Examining Latino Differences in Mental Healthcare Use: The Roles of Acculturation and Attitudes Towards Healthcare
We investigate the relative contribution of self-reliant attitudes and culturally specific factors in mental healthcare services for Latinos of Mexican, Cuban and Puerto Rican origin.
Findings presented regarding childhood and adult religiosity/spirituality as protective factors against Lifetime Alcohol Abuse.
Eliminating racial/ethnic disparities in access and quality of mental care has emerged as a national priority as highlighted in the 2001 Surgeon General’s report, the President’s New Freedom Commission on Mental Health, and Healthy People 2000 and 2010. The National Institutes of Health (NIH) ranks this issue third among its top five priorities.
MISSION Diversion & Recovery for Traumatized Veterans (MISSION DIRECT VET): Early Findings and Lessons Learned
MISSION DIRECT VET is a SAMHSA- funded, court based diversion program targeting veterans in Massachusetts with trauma-related mental health and substance use problems. MISSION-DIRECT VET seeks to: Reduce criminal justice involvement Treat mental health, substance abuse and other trauma related symptoms Use a systematic wrap-around model Provide care coordination, peer support and trauma informed services Develop interagency partnerships to serve veterans with co-occurring disorders
MISSION Diversion & Recovery for Traumatized Veterans (MISSION DIRECT VET): Early Planning and Development
MISSION DIRECT VET is a SAMHSA- funded, court based diversion program targeting veterans in Massachusetts with trauma-related mental health and substance use problems. MISSION-DIRECT VET seeks to: Reduce criminal justice involvement Treat mental health, substance abuse and other trauma related symptoms Use a systematic wrap-around model Provide care coordination, peer support and trauma informed service.
The Mental Health Agency Research Network (MHARN): Developing a statewide network for knowledge sharing, technical assistance & collaborative research
The Mental Health Agency Research Network (MHARN) is a developing network for sharing knowledge and research collaboration between the UMMS Dept. of Psychiatry and other academics, DMH personnel, community providers, consumers and family members. Its mission is to close the gap between science and service in mental health services in Massachusetts by improving implementation of evidence based practices to benefit consumers. The MHARN provides a structure and mechanism for the Center for Mental Health Services Research (CMHSR) to better engage with DMH staff and community agencies around the state. As experience and research on science-to-service has demonstrated that dissemination of information about research findings is not sufficient to bring about changes in practice and benefits to consumers, the MHARN will incorporate principles and practices of the emerging science of implementation research.
Development of a Self-report Measure of Dual Diagnosis Capability for Addiction and Mental Health Programs
The purpose of this study is to develop and test the psychometrics of a self-report version of a measure of the capacity of addiction and mental health programs to deliver dual-diagnosis treatment, that is, to provide treatment for both addiction problems and mental health problems. Traditionally these services are provided by very different service providers that did not until recently interact very well, if at all. The increasing recognition that patients who suffer from both kinds of problems – who are dually diagnosed – would benefit from integrated delivery of addiction and mental health services has led to efforts to encourage provision of such integrated services in programs that have tended to focus primarily on the delivery of either addiction or mental health services to the exclusion of the other. In order to assess how well the integration of these services is progressing, various measures have been developed, one of which is the original Dual Diagnosis Capability in Addiction Treatment (DDCAT) Index. The DDCAT, as it now stands, however, is a very time-intensive tool. It requires a rater to visit a site and spend one half to a full day there interviewing administrators, therapists, and patients, reviewing medical records, and attending meetings. The purpose of this study is to test a self-report version of the DDCAT that will be administered to administrators and therapists to see how well it performs compared to the more time- intensive procedures of the original DDCAT.
On May 27, 2008, UMass Memorial Health Care and The University of Massachusetts Medical School implemented a complete tobacco- free policy, both indoors and outdoors-- for all properties, including parking facilities and in vehicles parked there. This ban is for all tobacco products, including chewing tobacco, and extends to everyone who smokes--patients, visitors, employees, students and vendors.
Research in the areas of co-occurring depression, heart disease, diabetes, asthma and schizophrenia are extensive. However, a comprehensive account of physical illnesses among those with many types of mental illnesses is scarce. To estimate the prevalence of common chronic physical illnesses among a nationally representative sample of adults under 65 years of age with mental illness and examine the demographic, socioeconomic, and health status predictors of co-occurring physical and mental illness.
Incorporating Tobacco Cessation with Health Promotion Activities in a Psychosocial Rehabilitation Clubhouse
Many people with Severe Mental Illness (SMI) use smoking to manage symptoms, stress, or increase social contact, and consume nearly half of all tobacco sold in the US. Compared with the general population, individuals with SMI are at greater risk of co-morbid health problems and premature death. Often individuals with SMI are unaware that services like Quitlines, Nicotine Anonymous (NIC-A) meetings, and/or NRT exist. To compound matters, many states (e.g. Massachusetts) have cut tobacco cessation funding, and few programs provide integrated approaches to tobacco cessation in mental health settings that include peer supports. The lack of services and large disparities in smoking rates and health outcomes in people with SMI have resulted in a national crisis. There is a need to implement and evaluate cost-effective interventions that attempt to decrease morbidity and mortality associated with tobacco use among people with SMI. Our efforts engage this population in integrating a manualized tobacco control intervention, “Learning About Healthy Living” (LAHL) and training in use of Breath Carbon Monoxide (CO Meters) to track the progress of tobacco use among members and staff in the Clubhouse Model. Our project joins experts in tobacco dependence treatment for adults with SMI from UMass with leaders in the Clubhouse Model from Genesis Club in Worcester, MA.
Research presented on improving supports for transition age youth and young adults who have serious mental health conditions and want to complete schooling and training to move into work lives, through actively participating in the research and dissemination process.
Creating a “Community of Practice” on Transition Age Youth & Young Adults With Serious Mental Health Conditions in Northeast Massachusetts
The Northeast Massachusetts Community of Practice for Transition Age Youth and Young Adults (MACOPTAYYA) was initiated through the involvement of a champion, a regional director of the state Departmentof Mental Health (DMH). With support from the Transitions Research and Training Center (RTC), the CoP built a partnership of committed stakeholders from various points of the system of service for Transition Age Youth and Young Adults, thus building bridges across the adult and children mental health agencies.
Implementing the Massachusetts Child Trauma Project (MCTP) to Improve Services for Children with Complex Trauma in Child Welfare: Phase I Needs and Readiness Assessment
MCTP seeks to improve placement stability and outcomes for children with complex trauma in the care of the Massachusetts Department of Children and Families (DCF) by creating a sustainable capacity for providing evidence-based trauma interventions within provider agencies, and trauma-informed practices within DCF.
Approximately 760,000 emerging adults use outpatient psychotherapy in the U.S. each year (Olfson et al.,2002). Emerging adults are 1.6-7.9 times more likely to drop out of mental health treatment than fully mature adults (Edlund et al., 2002; Olfson et al., 2002). This Study compared temporal patterns of attendance and non attendance between emerging and mature adults
The Child Welfare League of America (2003) reported that between 1980 and 2000 the arrest rate for boys declined by 11% but increased for girls by 35%. A well tested case management approach being applied more commonly in juvenile justice is the Risk-Needs-Responsivity (RNR) approach, which suggests that interventions and services should be commensurate with ones level of risk and specific dynamic risk factors (criminogenic needs). The RNR model tends to be seen as "gender-neutral", based on assumption that it works equally well with both sexes. Few studies have examined whether gender differences exist in the effectiveness of RNR-type case planning.
Vitopoulos et al., (2012) examined possible RNR differences between justice-involved boys and girls using the Youth Level of Service/Case Management Inventory (YLS/CMI). Across all of the criminogenic need areas (e.g. antisocial attitudes, peer affiliations), only the personality domain was significantly different by gender, such that more girls than boys seemed to have a problem inthis area. They did not find any gender differences in the matching of services to needs identified; however, a higher match between clinician-recommended needs and assigned treatment services (service-to-needs match) predicted a decrease in boys' re-offending but not in girls' reoffending. Given the paucity of research, we are left to question the applicability of some RNR principles or the quality of their implementation for girl offenders. Using the Structured Assessment of Violence Risk for Youth (SAVRY)) in three probation officies to measure both risk level and dynamic risk factors (criminogenic needs), we examined whether within a large sample of youth there were gender differences in the (a) criminogenic needs identified, (b) ability of probation officers (POs) to match services to needs in their case planning and (c) the association of the serve-need match to recidivism.
Relationships as the Foundation of Shared Decision Making: The Experience of Young Adults with Mental Health Conditions
To describe the experience of young adults with serious mental illness as active participants in making medication decisions with their psychiatrists.
Findings from a study of women with lived experience of depression during and after pregnancy, specific to what is helpful, what are barriers and how to affect change.
Findings presented on using life coaches to provide vocational supports to emerging adults including statistics, types of services, a curriculum and skills inventory.
X-chromosome inactivation (XCI), the random transcriptional silencing of one X chromosome in somatic cells of female mammals, is a mechanism that ensures equal expression of X-linked genes in both sexes. XCI is initiated in cis by the noncoding Xist RNA, which coats the inactive X chromosome (Xi) from which it is produced. However, trans-acting factors that mediate XCI remain largely unknown. Here, we perform a large-scale RNA interference screen to identify trans-acting XCI factors (XCIFs) that comprise regulators of cell signaling and transcription, including the DNA methyltransferase, DNMT1. The expression pattern of the XCIFs explains the selective onset of XCI following differentiation. The XCIFs function, at least in part, by promoting expression and/or localization of Xist to the Xi. Surprisingly, we find that DNMT1, which is generally a transcriptional repressor, is an activator of Xist transcription. Small-molecule inhibitors of two of the XCIFs can reversibly reactivate the Xi, which has implications for treatment of Rett syndrome and other dominant X-linked diseases. A homozygous mouse knockout of one of the XCIFs, stanniocalcin 1 (STC1), has an expected XCI defect but surprisingly is phenotypically normal. Remarkably, X-linked genes are not overexpressed in female Stc1(-/-) mice, revealing the existence of a mechanism(s) that can compensate for a persistent XCI deficiency to regulate X-linked gene expression.
Both classical brown adipocytes and brown-like beige adipocytes are considered as promising therapeutic targets for obesity; however, their development, relative importance and functional coordination are not well understood. Here we show that a modest expression of miR-378/378* in adipose tissue specifically increases classical brown fat (BAT) mass, but not white fat (WAT) mass. Remarkably, BAT expansion, rather than miR-378 per se, suppresses formation of beige adipocytes in subcutaneous WAT. Despite this negative feedback, the expanded BAT depot is sufficient to prevent both genetic and high-fat diet-induced obesity. At the molecular level, we find that miR-378 targets phosphodiesterase Pde1b in BAT but not in WAT. Indeed, miR-378 and Pde1b inversely regulate brown adipogenesis in vitro in the absence of phosphodiesterase inhibitor isobutylmethylxanthine. Our work identifies miR-378 as a key regulatory component underlying classical BAT-specific expansion and obesity resistance, and adds novel insights into the physiological crosstalk between BAT and WAT.