Espiritismo and Santeria: a gateway to child mental health services among Puerto Rican families?

Background Barriers to mental health care access among Latinx children contribute to mental health disparities. It is unclear whether traditional spiritual guides in Latinx communities may function more as gateway providers or in some instances as deterrents to mental health treatment. This study assesses whether family involvement in Espiritismo and/or Santeria, two forefront non-Christian spiritual traditions among Latinx families, is associated with mental health care utilization among Puerto Rican children in two contexts. Methods Data are from Waves 1–3 (2000–2004) of the Boricua Youth Study, a population-based longitudinal cohort study of Puerto Rican children from San Juan and Caguas, Puerto Rico (PR), and the South Bronx, New York (SBx), 5 to 17 years of age (N = 2491). Results At baseline, 5.02% (n = 58) of the families reported involvement with Espiritismo and/or Santeria in the SBx and 3.64% (n = 52) in PR. Logistic regression models predicting mental health service use found, after adjusting for multiple risk and protective factors, that families involved with Espiritismo and/or Santeria were 2.41 times more likely (p = 0.0034) to use mental health services over the course of 3 years than children with no family involvement in these practices in the SBx. The same association was not found in PR. Conclusions The findings among PR families in the SBx lend support to the gateway provider model in which spiritual guides open doors to mental health treatment. Forming community connections between mental health providers and traditional spiritual groups may be a culturally considerate, fruitful approach to reducing barriers to mental health treatment among Latinx families.

Christian Mindfulness and Mental Health: Coping through Sacred Traditions and Embodied Awareness

Mindfulness is increasingly implemented as a tool in mental health practice for coping and self-care. Some Christians worry that these practices might be in conflict with their own tradition, while other Christian contexts are reclaiming the contemplative aspects of the faith. Though clinicians are not trained to teach on religious topics and ethically must avoid pushing religion onto clients, conceptualization and research extend the benefits of mindfulness practices for religious clients. This paper will discuss the evidence for using mindfulness in mental health treatment and connect mindfulness to the Christian tradition. The authors explore how intentional awareness and embodiment of the present moment are supported in Christian theology through the incarnation of Jesus and God’s attention of the physical body in the Christian scriptures. The authors also discuss how sacraments and prayer naturally overlap with mindfulness practices for the dual purposes of emotional healing and spiritual growth. To bolster the benefits of mindfulness in the psychological and religious realms, the purpose of this paper is to empower therapists to address client concerns of whether mindfulness is in conflict with Christianity, support clients in expanding current Christian religious coping, and provide Christian leaders with more information about how mindfulness elements are already present in Christian rituals and beliefs.

Mental Health Treatment Histories, Recovery, and Well-being

Epidemiological and sociological research on recovery from mental disorder is based on three rarely tested medical model assumptions: (1) recovery without treatment is the result of less severe illness, (2) treatment predicts recovery, and (3) recovery and well–being do not depend on individuals’ treatment histories. I challenge these assumptions using National Comorbidity Survey-Replication data for individuals with any disorder occurring prior to the current year ( N = 2,305). Results indicated that (1) untreated remissions were fully explained by less serious prior illness, (2) treated individuals were less likely to recover due to more serious illness, and (3) people who had past–only treatment were more likely to recover than the never–treated, while those in recurring and recently initiated care were less likely to recover. Treatment histories predicted greater well–being only if recovery had been attained. Histories of care help to explain recovery rates and suggest new directions for treatment–seeking theory and research.

Emotion regulation-enhanced group treatment for gambling disorder: a non-randomized pilot trial

Background Despite the association of Gambling Disorder (GD) with poor mental health, treatment options generally lack components targeting emotional difficulties. This study investigated the feasibility and acceptability of adding strategies of emotion regulation to an eight-session weekly group treatment. Method This non-randomized pilot study recruited 21 treatment-seeking adults with GD, (mean age = 36.3, 19% females) from addiction care. In a mixed methods design, measures of within-group changes in self-reported symptoms of GD were complemented with thematic analysis of post-treatment interviews regarding the feasibility of the treatment. Results Within-group scores on the Gambling Symptoms Assessment Scale (G-SAS) showed a 47% decrease (β: -0.1599, 95% CI: − 0.2526 to − 0.0500) from pre-treatment to 12-month follow-up, with Hedges’ g = 1.07 (CI: 0.57–1.60). The number of GD-symptoms according to the Structured Clinical Interview for Gambling Disorder (SCI-GD) decreased from 7.0 (SD = 1.60) at pre-treatment to 2.1 (SD = 2.36) at 12-month follow-up. Participants completed an average of 6.3 sessions and rated the intervention high in satisfaction and acceptability. Feasibility interviews showed no noticeable negative effects or ethical issues. Furthermore, helpful components in the treatment were: increased awareness of emotional processes and strategies to deal with difficult emotions. Conclusions Adding emotion regulation strategies in the treatment of GD is feasible and acceptable and warrants further investigation in a controlled trial. Trial registration This study was registered with ClinicalTrials.gov (Identifier NCT03725735).

The extent to which non-conditional housing programs improve housing and well-being outcomes: a systematic review

Purpose To reduce rates of homelessness, recent efforts have been directed toward developing non-conditional supported housing programs that prioritize the delivery of housing support and individual services, without tenancy conditions (i.e. maintaining sobriety and adhering to mental health treatment). As promising as these programs are, findings generally show that while housing stability is improved, other individual outcomes remain largely unchanged. No review to date has synthesized the collective evidence base of non-conditional housing programs, rather the focus has been on specific programs of delivery (e.g. Housing First) or on specific population groups (e.g. those with mental illness). The purpose of this paper is to evaluate the extent to which non-conditional housing interventions improve housing and well-being outcomes for all persons. Design/methodology/approach A systematic search of the literature was conducted for randomized controlled studies that evaluated the effectiveness of a non-conditional housing intervention in improving housing and health outcomes among any participant group. Findings A total of 31 studies were included in this review. Non-conditional supported housing programs were found to be most effective in improving housing stability as compared to health and well-being outcomes. Policymakers should consider this when developing non-conditional supported housing programs and ensure that housing and other health-related outcomes are also mutually supported. Originality/value This is the first review, to the authors’ knowledge, to synthesize the collective impact of all non-conditional supported housing programs. The current findings may inform the (re)design and implementation of supported housing models to prioritize the health and well-being of residents.

Social isolation induces neuroinflammation and microglia overactivation, while dihydromyricetin prevents and improves them

Background Anxiety disorders are the most prevalent mental illnesses in the U.S. and are estimated to consume one-third of the country’s mental health treatment cost. Although anxiolytic therapies are available, many patients still exhibit treatment resistance, relapse, or substantial side effects. Further, due to the COVID-19 pandemic and stay-at-home order, social isolation, fear of the pandemic, and unprecedented times, the incidence of anxiety has dramatically increased. Previously, we have demonstrated dihydromyricetin (DHM), the major bioactive flavonoid extracted from Ampelopsis grossedentata, exhibits anxiolytic properties in a mouse model of social isolation-induced anxiety. Because GABAergic transmission modulates the immune system in addition to the inhibitory signal transmission, we investigated the effects of short-term social isolation on the neuroimmune system. Methods Eight-week-old male C57BL/6 mice were housed under absolute social isolation for 4 weeks. The anxiety-like behaviors after DHM treatment were examined using elevated plus-maze and open field behavioral tests. Gephyrin protein expression, microglial profile changes, NF-κB pathway activation, cytokine level, and serum corticosterone were measured. Results Socially isolated mice showed increased anxiety levels, reduced exploratory behaviors, and reduced gephyrin levels. Also, a dynamic alteration in hippocampal microglia were detected illustrated as a decline in microglia number and overactivation as determined by significant morphological changes including decreases in lacunarity, perimeter, and cell size and increase in cell density. Moreover, social isolation induced an increase in serum corticosterone level and activation in NF-κB pathway. Notably, DHM treatment counteracted these changes. Conclusion The results suggest that social isolation contributes to neuroinflammation, while DHM has the ability to improve neuroinflammation induced by anxiety.

A Case of the Tail Wagging the Dog: The Medicare Mental Health Coverage Gap and Its Impact on Providers and Beneficiaries

Nearly one in four Medicare beneficiaries have been diagnosed with mental health or substance use disorders, and research indicates this population responds well to mental health treatment. However, Medicare policy omits licensed mental health counselors (LMHCs) and licensed marriage and family therapists (LMFTs) as approved providers, exacerbating an existing national provider shortage. Emerging research demonstrates that the provider omission, referred to as the Medicare mental health coverage gap (MMHCG), profoundly impacts excluded providers and the communities they serve. This paper represents a synthesis of the most current scholarship on Medicare research, policy, and advocacy. In particular, we explore three ways the MMHCG impacts providers and beneficiaries alike: limiting provider choices, thwarting continuity of care, and creating challenging decisions for beneficiaries and providers. Our aim is to help mental health counselors better understand and navigate the MMHCG and aid in advocacy efforts for legislation to include LMHCs and LMFTs as approved Medicare providers.

PARTNER-MH, a Peer-Led Patient Navigation Intervention for Racial and Ethnic Minority Veterans in Veterans Health Administration (VHA) Mental Health Services: A Mixed-Methods Randomized Controlled Feasibility Trial Study Protocol

Background: Mental healthcare disparities are persistent and have increased in recent years. Compared to their White counterparts, racial and ethnic minority groups have less access to mental healthcare. Minority groups also have lower engagement in mental health treatment and are more likely to experience ineffective patient-provider communication, which contribute to negative mental healthcare experiences and poor mental health outcomes. Interventions that embrace recovery-oriented practices to support patient engagement and empower patients to participate in their mental healthcare and treatment decisions may help to reduce mental healthcare disparities. Designed to achieve this goal, PARTNER-MH is a peer-led, patient navigation intervention that aims to engage minority patients in mental health treatment, support them to take a greater role in their care, and facilitate their participation in treatment shared decision-making. Methods: This pilot study evaluates the feasibility and acceptability of PARTNER-MH in a VHA mental health setting using a mixed-methods, randomized controlled trial study design. PARTNER-MH is tested under real-world conditions, using certified VHA peer support specialists (peers), selected via usual VHA hiring practices and assigned to the mental health service. The peers provide PARTNER-MH and usual peer support services. The study compares the impact of PARTNER-MH versus a wait-list control group on patient activation, patient engagement, and shared decision-making, as well as other patient-level outcomes. PARTNER-MH also examines organizational factors that could impact its future implementation in VHA settings. Results: Participants (N=50) were veterans who were mostly male (62%), self-identified as non-Hispanic Black (70%), with a median age in the 45-54 group. Most had at least some college education, and 32% completed 4 or more years of college. Randomization produced comparable groups in terms of characteristics and outcome measures at baseline, except for gender. Discussion and Conclusion: Rather than simply documenting health disparities among vulnerable populations, PARTNER-MH offers opportunities to evaluate a tailored, culturally-sensitive system-based intervention to improve patient engagement and patient-provider communication in mental healthcare for racial and ethnic minorities. IRB Protocol #1708628270Trial registration: ClinicalTrials.gov, NCT04515771. Registered 14 August 2020, https://clinicaltrials.gov/ct2/show/NCT04515771