News & Announcements

Center Brings Hope to Homeless Struggling with Mental Illness by Providing Peer Support Services

Posted: August 08, 2012

Catering to mentally ill homeless individuals and staffed by workers who have struggled with the same problems, the HOPE Wellness and Recovery Center is providing a critical safety net in Baltimore. The center, which opened in February 2001, is the only facility of its kind in the state, says its executive director, Thomas Hicks. HOPE’s singular mission has helped it avoid the budget cuts that have plagued other programs in the state mental health system. The mission is clear from its name: Helping Other People through Empowerment. Hicks, 58, said the nine staff members at HOPE are not interested in forcing clients to get care. "Our purpose here is to try to get you to understand, to empower you to get a better quality of life if that’s what you want to do," Hicks said. "And if that’s not what you want to do and you still meet the criteria, you’re still perfectly welcome." Individuals must provide proof of a mental illness diagnosis in order to take part in the program. 

Staff members put clients in contact with case managers to help them find housing or therapists to help them manage their symptoms. The center also provides basic services such as laundry, showers, Internet access, meals and entertainment. But clients receive more than just clean clothes and warm food — they see a future through the eyes of others who have overcome similar obstacles. Because of their common perspectives, employees share in the process of recovery with clients, who find their way to HOPE either by referral or word-of-mouth.

Client Vernell Lewis, 58, said he suffers from psychotic depression, a condition he said has led him to attempt suicide six times. He said he has been going to HOPE since 2006, and that simply talking to peers, and being able to relax with them by playing games such as chess or cards, has helped. "We try to respect each other; that's one of the things that's important," he said. 

The employees at HOPE might be better equipped to provide that push toward recovery, said Brian M. Hepburn, executive director of the Maryland Mental Hygiene Administration. "The advantage, of course, is that there may be more trust for people who have previously had a similar life experience," Hepburn said. The center’s model sets it apart from many other programs for the mentally ill, officials said. "Peers play a critical role in service delivery in our system," Taylor added. "We find them in a lot of programs, but this is a center that provides a relaxed, comfortable environment for people to interact with peers." Hepburn said peer-to-peer support is more common in substance abuse treatment and is relatively new to the mental health community. But the advocacy group On Our Own of Maryland, which assists people diagnosed with mental illness, has made inroads with it.

Read more on the Kaiser Health News website. Visit the HOPE Wellness and Recovery Center website


Mental Health Care Scarce for Kids in Child-Welfare System

Posted: August 06, 2012

Young children who are the subject of investigations by child-welfare agencies because of allegations of maltreatment have a higher prevalence of mental health problems than their peers, and very few receive treatment for those problems. This is the focus of a new study titled Mental health problems in young children investigated by U.S. child welfare agencies published in the Journal of the American Academy of Child and Adolescent Psychiatry.

Sarah McCue Horwitz, Ph.D., a professor in the Department of Pediatrics and the Centers for Health Policy and Primary Care and Outcomes Research at Stanford University, and colleagues made that pronouncement after evaluating data from the second National Survey of Child and Adolescent Well-Being (NSCAW II), a longitudinal study of 5,872 children from infancy to age 17.5 referred to child-welfare agencies for an investigation of potential maltreatment. The investigations were completed during the sampling period, February 2008 to April 2009. 

For children aged 12 to 18 months who were part of the survey, caregivers were administered the Brief Infant-Toddler Social Emotional Assessment (BITSEA), a 42-item screening tool designed to identify children at risk for social-emotional problems and low social competence. For children aged 19 to 36 months, caregivers were administered the Child Behavior Checklist 1.5-5 (CBCL 1.5-5).

The results were disturbing: in all, the scores for 34.6 percent of children aged 12 to 18 months were high on the Problem Scale of the BITSEA, and 20.9 percent on the Competence Scale, while for 10 percent of those aged 19 to 36 months the scores were over the CBCL clinical cutoff, indicating the need for mental health services. Children of black ethnicity were less likely to have elevated scores on the BITSEA Problem Scale, and children who lived with a never-married caregiver were five times more likely to have elevated scores.

Competence problems were associated with prior child-welfare-system history, and elevated CBCL scores were associated with living with a depressed caregiver. But what the researchers found distressing was that few of the children with identified mental health problems—only 2.2 percent— received mental health services.

Read more on Psychiatry News Online. Read the abstract of the study.

The Importance of Teen Substance Use Prevention in the LGBTQ Community

Posted: August 05, 2012

According to a report by the Centers for Disease Control and Prevention, gay, lesbian, and bisexual high school students are at higher risk for alcohol and drug abuse than heterosexual students. During Pride Month, David K. Mineta, Deputy Director of Demand Reduction for the Office of National Drug Control Policy, met with leaders and advocates from the LGBTQ community to talk about substance use and other important issues facing those who are “differently” oriented. He told them how proud he was to work for a President who has made more LGBTQ appointments than any before him and whose Administration is committed to securing equality for all citizens, regardless of race, creed, or sexual orientation.

They also talked about the importance of prevention – stopping substance use before it begins and identifying drug-related problems early. Alcohol and drugs can wreak havoc on even the most supportive and nurturing environments, so it is crucial for these young people, and indeed for all Americans, to remain vigilant against the threat. 

The Obama Administration has made drug-use prevention one of their top priorities and has devoted substantial resources to supporting community-based coalitions around the country through the Drug Free Communities Support Program. These coalitions work to address local health and safety issues, including those faced by LGBTQ youth. Among the other powerful tools available for preventing substance abuse is ONDCP’s “Above the Influence” Campaign, which gives teens information and a national platform to talk about staying above the influence of drugs and alcohol. 

Read more on the Reclaiming Futures website. 


Circle of Life HIV/AIDS Prevention Intervention for American Indian and Alaska Native Youth

Posted: August 03, 2012

This article describes the objectives, theoretical bases, development process, and evaluation efforts to-date for the Circle of Life curricula, HIV/AIDS prevention interventions designed for American Indian and Alaska Native youth. The curricula are based on Indigenous models of learning and behavior encompassing concepts of Western theories of health behavior change. The curricula underwent extensive national and community review. Subsequent advances include the development of a computer-based version of the intervention.

A review of the interventions aimed at HIV prevention for youth reveals a growing list showing success in sexual risk reduction. While these reviews have provided useful guidance for many youth-serving programs, absent from these lists is an intervention designed specifically for American Indian/Alaska Native (AI/AN) youth. Several factors contribute to this absence, including the challenges of generating sufficient scientific evidence to meet the standards required by such lists, the gaps created by inconsistent funding and shifting programmatic priorities, and the rapid change in technology and opportunities to use approaches to learning appropriate for AI/AN youth. In this brief article, the authors present the case of two curricula developed specifically for AI/AN youth: “Circle of Life: HIV/AIDS Curriculum for K-6” and “Circle of Life: HIV/AIDS and STD Prevention Curriculum for Middle School.” They outline the challenges and successes of development, implementation, and dissemination of these AI/AN youth-focused interventions. This history, coupled with strategic partnerships and escalating HIV prevention need in AI/AN communities, has propelled the two Circle of Life (COL) curricula forward, positioning them as meaningful and appropriate options for youth sexual risk prevention. The article begins by describing the development of COL, including the objectives of the curricula and their theoretical bases. It then describes the evaluations of the COL curricula, recent developments with respect to COL, and the promise of upcoming research efforts.

Read the abstract of the study. Read the full-text of the article (pdf).

Using Telepsychiatry for the Treatment of Depression in Underserved Hispanics

Posted: August 02, 2012

St. Elizabeth’s Health Center (St. Elizabeth’s) located in Tucson, Arizona, offers an array of medical, dental, counseling, and social services to its patient population. St. Elizabeth’s serves a highly underinsured and uninsured primarily Spanish speaking population. One respondent indicated at least 60% of the patient population identifies as Hispanic and approximately 97% of patients are uninsured or underinsured. The clinic also treats some undocumented immigrants who seek care.

Hispanics, the single largest and fastest growing minority group in the United Sates, face significant disparities in health and health care access. Research shows inadequate care for major depression among Hispanics. In April 2008, the University of Arizona College of Medicine, Department of Psychiatry (University of Arizona), in partnership with St. Elizabeth’s, received funding from the Robert Wood Johnson Foundation (RWJF) to conduct a project examining the acceptability and effectiveness of telepsychiatry depression treatment for low-income Hispanic adults provided by a psychiatrist through internet videoconferencing using a webcam. Prior to RWJF funding, the University of Arizona partnered with St. Elizabeth’s to conduct a telepyschiatry pilot project to determine the feasibility of using commercially available webcams to provide mental health services to patients in their primary care medical home.

As part of the RWJF project, which replicated the pilot on a larger scale, University of Arizona and St. Elizabeth’s staff screened approximately 160 patients into a study based on a diagnosis of major depressive disorder and other criteria. Researchers randomly assigned patients to one of two groups: an experimental group receiving the psychiatric webcam intervention, and the control group receiving “treatment as usual” care from their primary care provider and additional behavioral health services from a counselor if determined necessary. Researchers measured several depression outcome variables from physician and patient-rated perspectives, including quality of life, mental and physical functional abilities, and satisfaction with treatment, and assessed how acceptability and clinical response are impacted by levels of acculturation, severity of illness, age, and gender. 

Read the full report (pdf).

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