Social Integration and Mental Well-Being Among Jail Inmates

Although social integration has consistently been linked to mental well-being among the general population, this relationship has not been explored for persons confined in total institutions. Jails, in particular, represent unique conditions that have the potential to alter the traditional relationship between social ties and mental health. Although previously unexamined, social ties maintained by jail inmates outside and inside of the institution are commonly presumed to weaken some of the adverse effects of a stressful environment and positively influence mental health. The current study explores the impact of social integration on mental well-being among 198 male and female inmates incarcerated in a large county jail. The impact of marital status, parental status, and social support (both inside and outside of the jail) on various dimensions of mental health was examined. The results indicate that rather than promoting mental well-being, social relationships inside and outside of the institution are associated with higher levels of distress. Specifically, married inmates report higher levels of depression and anxiety, and inmates with close social relationships inside of the jail report higher levels of hostility, although gender differences in these patterns are evident. The results of this study suggest that social integration may play a different role for persons incarcerated in total institutions than among the general population due to the unique conditions of social stigmatization and separation from support networks.     

Current and Prior Mental Health Treatment of Jail Inmates: The Use of the Jail as an Alternative Shelter

Changing policies in mental health and welfare are altering the character of urban jail populations. Homeless people, many of them ex–mental-hospital patients, occupy jail space in increasing numbers. They almost never commit violent crimes and seldom commit any real crime. They are given a charge and put in jail as a way to take them off the streets. The way in which official statistics are created and kept makes it difficult to demonstrate the nature and extent of this problem. This paper reports on one way this can be done.     

Reflective Narrations of Female Inmates: Dealing with Resistance During Adolescent Mental Health Treatment

Employing a qualitative approach, this study examines the adolescent mental health experiences of incarcerated women. Analysis of themes was presented from 20 semi-structured interviews and two focus groups. Emerging themes illuminated how past relationships and power inequities affect the therapeutic relationship and subsequently the resistance seen in the therapeutic setting. Those practitioners who incorporated techniques that encouraged personal power, relationship development, and expression of feelings were seen more positively and minimized resistance. Biases within the mental health community were seen in the participants' experiences, but most were covert rather than overt. Practice implications are recommended.     

Co-Occurring Disorders Among Female Jail Detainees: Implications for Service Delivery

ABSTRACT

The increase in the numbers of women incarcerated in prisons and jails has given rise to questions about their mental health and substance abuse treatment needs. This study used DSM-IV criteria to describe both lifetime and current diagnoses for substance use disorders, major depressive disorder, posttraumatic stress disorder and generalized anxiety disorder in a sample of 198 female jail detainees. Women were asked about readiness for treatment and AODA and mental health service use. Findings underscore the view that female jail detainees have complicated diagnostic histories and that the jail setting can provide opportunities for assessment and services.     

A Two-Level Community Intervention Model for Homeless Mothers with Mental Health or Substance Abuse Disorders

ABSTRACT

This paper describes a two-tiered community intervention model in response to a call from the Center for Mental Health Services for the development of best-practice strategies for homeless mothers with mental health and/or substance use disorders and their children. This model incorporates best practice principles gained from previous research projects pitched at the system and client levels. The model has been conceptualized, presented, and funded by CMHS and is currently being implemented in a local community. This model is unique in that it develops an intervention that addresses both levels of service delivery (i.e., system and client) in a single project. Blending systems integration/wraparound service philosophy and consumer-driven/strength-based development approaches provides a model that encompasses interventions at the individual client level via supported case management, and improved coordination and collaboration at the service system level. While this model was developed for a specific community population, the approach is general inits applicability to other areas of practice.     

Women's Experience of Co-Occurring Substance Abuse and Mental Health Conditions

ABSTRACT

This study explored the relationship between gender and co-occurring substance abuse and mental health conditions among a sample of 754 consumers of behavioral health services in the southwest U.S. Logistic regression was used to determine factors that would predict women's unique experience of dual diagnosis. Women were almost seven times more likely than men in this sample to have a diagnosis of posttraumatic stress disorder in conjunction with substance abuse. Women were also significantly more likely to experience anxiety and mood disorders and to have been married. Implications of these findings for social work practice are suggested.     

Substance Use and Mental Health Severity Among LGBTQ Individuals Attending Minnesota Model-Based Residential Treatment

This administrative data analysis examined substance use and mental health severity among a sample of lesbian, gay, bisexual, transgender, and questioning (LGBTQ) individuals receiving residential treatment for an alcohol or drug use disorder. LGBTQ were statistically compared to heterosexual patients on a number of variables, including frequency and amount of pretreatment alcohol use, frequency of pretreatment illicit drug use, co-occurring Axis I mental health diagnoses, and past history of physical or sexual abuse. LGBTQ patients exhibited significantly greater severity on nearly all variables, suggesting a strong relationship between clinical severity and being a sexual minority. This study also found a relationship between patient gender and the pattern of differences between LGBTQ and heterosexual patients. These results replicate and extend those of studies examining LGBTQ in the general population and suggest opportunities for development of alcohol/drug treatment approaches that address the unique needs of LGBTQ.     

The Seven Challenges: An Effective Treatment for Adolescents with Co-Occurring Substance Abuse and Mental Health Problems

ABSTRACT

Recent developments in the provision of the substance abuse treatment for adolescents has included a focus on age appropriate treatment with consideration for adolescents' relatively low level of motivation for treatment and high incidence of co-occurring substance use and mental health problems. This study examines 3- and 6-month substance use and mental health outcomes for youth (n = 36) participating in The Seven Challenges Program. Results indicate significant reductions in both substance use and mental-health-related measures at 3 months with all measures except substance abuse frequency continuing to improve at the most distal 6-month assessment. The Seven Challenges treatment model is presented along with a discussion of the findings.     

Comorbid Substance Use and Mental Disorders Among Offending Youth

ABSTRACT

This study examines the offense, substance use, and mental illness characteristics for a subset of adolescent juvenile detainees receiving services through a federally funded system of care initiative. Findings indicate that 65% of these youth were comorbid for both mental and substance use disorders. Female detainees were at greater risk on almost every measure of mental health impairment and dual substance use and mental disorders. Study results highlight the need for effective, integrated treatment models that can serve youth involved in multiple child-serving systems, and address the challenging constellation of comorbid conditions faced by many juvenile offenders.     

Computerized Behavioral Interventions: Current Products and Recommendations for Substance Use Disorder Treatment

Unlike traditional methods of delivering substance use disorder (SUD) and mental health treatment, computerized behavioral interventions deliver services via computers, smartphones, and other electronic devices. In recent years, there has been a proliferation of Web-based treatment programs designed for certain target populations. Studies have shown that many of these programs are evidence-based, and some are just as effective as traditional in-person interventions. This article reviews current computerized behavioral interventions and makes recommendations for how these tools can be incorporated into SUD treatment services.     

Symptoms of Eating Disorders Among Females in Drug Addiction Treatment

The aim of this study is to measure and describe symptoms of eating disorders among females in treatment for drug addiction in Norway. Previous clinical and epidemiological studies have revealed coprevalence between eating disorders and substance use or abuse. However, few studies have measured eating disorders in drug-using samples and even fewer within the context of drug treatment. In this study, 29 females with drug use disorder in residential treatment were tested with the Eating Disorder Inventory–2. A subgroup of 9 females (31%) with significant symptoms of eating disorders was identified. The characteristics of this group and possible clinical consequences are discussed.     

Self-rated Health in Relation to Rape and Mental Health Disorders in a National Sample of College Women

Abstract

Objective: The purpose of this study was to employ a multivariate approach to examine the correlates of self-rated health in a college sample of women, with particular emphasis on sexual assault history and related mental health outcomes. Participants: A national sample of 2,000 female college students participated in a structured phone interview between January and June 2006. Methods: Interview modules assessed demographics, posttraumatic stress disorder, major depressive episode, substance use, rape experiences, and physical health. Results: Logistic regression analyses showed that poor self-rated health was associated with low income (odds ratio [OR] = 2.70), lifetime posttraumatic stress disorder (OR = 2.47), lifetime major depressive episode (OR = 2.56), past year illicit drug use (OR = 2.48), and multiple rape history (OR = 2.25). Conclusions: These findings highlight the need for university mental health and medical service providers to assess for rape history, and to diagnose and treat related psychiatric problems in order to reduce physical morbidity.     

Gender Differences in the Path From Sexual Victimization to HIV Risk Behavior Among Homeless Youth

ABSTRACT

Experiencing sexual victimization prior to becoming homeless is common among homeless youth and is associated with increased HIV risk behavior. This study examined mediating variables that underlie this association, adding to the understanding of gender differences in these paths. Participants were homeless youth in Los Angeles recruited through service access centers who completed a computerized self-administered interview in English or Spanish using an iPad. Findings indicate a high presence of sexual victimization across both genders. Female participants experienced posttraumatic stress disorder and subsequent engagement with exchange sex, whereas male participants were primarily involved in substance use risk pathways. Results indicate paths in the association between sexual victimization and HIV risk behavior differ between male and female homeless youth. Gender-specific, mental-health-informed interventions targeting sexual risk reduction are warranted.     

Perceived Discrimination and Its Associations With Mental Health and Substance Use Among Asian American and Pacific Islander Undergraduate and Graduate Students

Abstract

Objectives: Racial discrimination experiences can negatively affect health. This study examined perceived discrimination and its relationship with mental health and substance use among Asian American and Pacific Islander (API) undergraduate and graduate students. Participants: A total of 113 API students aged 18–35 completed the study during February–June, 2011. Methods: The authors conducted a cross-sectional, anonymous survey online. Dependent variables included mental health (depressive, anxiety, and somatic symptoms) and substance use (alcohol problems, use of tobacco, marijuana or hashish, and other illegal drugs). Results: Students’ perceived discrimination were significantly, positively associated with depressive, anxiety, and somatic symptoms, but not with substance use. Ethnic identity moderated the relationship between perceived discrimination and somatic symptoms, but not depressive or anxiety symptoms. Conclusions: These findings suggested the negative effect of racial discrimination on API students’ mental health. The buffering effect of ethnic identity may increase resilience in these students when they face racial discrimination.     

Bridging the gaps: Intergenerational findings from the substance use disorder and recovery field

The substance use disorder and recovery field has undergone rapid transformation over the last 40 years. It currently has a workforce that includes three generations—Baby Boomers, Generation X, and Millennials. The current study sought to identify generational differences among those involved in the substance-use disorder and recovery profession using an embedded design and grounded theory approach. Findings suggest that generational differences do exist across the three generations in regard to ideologies, value of formal and informal knowledge, training, and education. Results from the current study provide a further understanding of how we may bridge perceived contentious ideologies and knowledge gaps between generations to better develop current and future professionals within the field.     

Prevalence of Traumatic Events and PTSD Symptomatology Among a Selected Sample of Undergraduate Students

Abstract

University faculty and mental health counselors often work with students in distress which may be related to their experiences with traumatic accidents, interpersonal violence, or natural disaster. Traumatic events can have long-lasting effects, which include somatic complaints, substance abuse, “flashbacks,” and a reduction in memory and recall. The purpose of this study is to identify the number, types and severity of traumatic events that occur among a student sample from three academic departments (Sociology and Criminal Justice, Social Work, and Human Development) at a rural southern university. The sample of 234 undergraduate students confirmed previous research regarding the high number of self-reported traumas among college students. The study found that college-aged women are much more likely than men to report trauma and to seek counseling and treatment for its effects. Significant differences were noted in distributional patterns for men and women when reporting exposure to stressful events. The study's findings serve as an important indicator of the need for prevention, early recognition, and treatment for trauma victims. Suggestions are also provided to assist administrators in implementing the appropriate workplace and academic accommodations for PTSD victims under the Americans with Disabilities Act (ADA) and the Rehabilitation Act of 1973 (Section 504).     

Current and Prior Mental Health Treatment of Jail Inmates: The Use of the Jail as an Alternative Shelter1 2

Changing policies in mental health and welfare are altering the character of urban jail populations. Iiomeless people, many of them ex-mental-hospital patients, occupy jail space in increasing numbers. They almost never commit violent crimes and seldom commit any real crime. They are given a charge and put in jail as a way to take them off the streets. The way in which official statistics are created and kept makes it difficult to demonstrate the nature and extent of this problem. This paper reports on one way this can be done.     

Problem Gambling and Comorbid Psychiatric and Substance Use Disorders Among Drug Users Recruited from Drug Treatment and Community Settings

Little is known about gambling rates of drug users recruited from drug treatment compared with those recruited from the community. We use the Diagnostic Interview Schedule (DIS) to provide lifetime prevalence estimates of problem gambling (i.e., at least one gambling problem) and DSM-III-R pathological gambling (i.e., at least four gambling problems) and describe the association between gambling and psychiatric disorders for drug users recruited from drug treatment settings (n = 512) and from the community (n = 478). We also report the relative risk of being a recreational and problem gambler in this sample. The sample was first interviewed in 1989–90 as a partof two NIDA-funded St. Louis-based studies. The prevalence of problem gambling in the overall sample was 22% and the prevalence of pathological gambling was 11%. There were no statistically significant differences in problem and pathological gambling rates for subjects recruited from drug treatment and those recruited from the community. The conditional prevalence rates, that is, the rate of problem and pathological gambling only among gamblers were 27% and 13.5%, respectively. Major findings indicate that problem gambling was associated with Antisocial Personality Disorder (ASPD), even after controlling for recruitment source and socio-demographic characteristics. In fact, when examining the temporal order of these disorders, we found that pathological gambling was always secondary to ASPD, occurring on average 11.4 years after the onset of ASPD. Problem gamblers, compared with everyone else, were more likely to be male, African-American, recruited from drug treatment, have ASPD and be dependent on illicit drugs. Multinomial logistic regression analysis predicted the relative risk of being a recreational and problem gambler (compared with a nongambler) in this sample according to socio-demographics, ASPD, and dependence on illicit drugs. Results imply that screening for gambling problems will need to be broad-based among drug users.     

Dual Relationships: The Challenges for Social Workers in Recovery

ABSTRACT

Over the last ten years there is increasing focus in social work literature about non-sexual dual relationships. This has included consideration of different types of dual relationships that occur primarily during or after the establishment of professional social worker-client relationship. However, the specific concerns facing social workers who are themselves in recovery from substance use disorders remain absent from these discussions. This article identifies challenges facing social workers in recovery from substance use disorders who also work with clients dealing with these disorders. Recommended actions and policies that can assist professionals and agencies in balancing personal and practice issues are presented.