Mass incarceration is a public health issue that impacts millions of Americans. Draconian drug laws, over-policing, and unfair sentencing policies rooted in racism have led to the incarceration of millions of Black and Latinx people in the past four decades. Mass incarceration not only has collateral consequences for the health of the incarcerated, but also fortheir partners and children across multiple dimensions. This cross-sectional study recruited participants using social media, email, and text messages. Those who identified as Black or Latinx, age 20 or older, and who had a partner who was incarcerated for at least three months were eligible for study participation. The study was novel in asking for ratings of physical and mental/emotional health for four time periods: before their partner’s incarceration, after their partner’s incarceration, the year after their partner’s release, and “now”/currently. Results showed significant declines in both physical and mental/emotional health (e.g., a decline in ratings for during their partner’s incarceration from the pre-incarceration level), as well as improvements (e.g., improvement for the period “now”/currently from the during incarceration level). Also, when rating their children for the same four time periods for physical health, mental/emotional health, behavioral conduct, and school performance, a similar pattern of both declines and improvements was found. Findings argued for the importance of a methodology using multiple time periods for obtaining ratings, and for a resilience framework to accommodate interpretation of improvements. Further, having a greater number of children, being currently employed, having a lower income, and a lower rating of mental health during their partner’s incarceration were four significant predictors found in the regression models for both study outcome variables: i.e., (1) a higher negative impact from a partner’s incarceration on multiple dimensions; and (2) more harmful mental health consequences for partners of the incarcerated. Findings provided evidence for an especially underserved at-risk subset within the population of diverse male and female partners of the incarcerated: i.e., Black and Latinx women with a high number of children who are employed yet earning low wages—while suffering from severe mental health symptoms. Implications of the findings and recommendations are discussed.

There is a growing acknowledgement of the importance of mental health and well-being among refugees and asylum-seekers as a result of high rates of mental distress. Most research, however, has focused on refugees and asylum-seekers who live in high-income countries, even though the vast majority (approximately 80 percent) reside in lower- and middle-income countries (LMICs). This three-paper dissertation brings attention to this research gap and examines issues surrounding the mental health of refugees and asylum-seekers living LMICs. Three different cross-sectional data sources were included in this dissertation from study participants recruited from Malaysia, Jordan, and Turkey in 2018. Additionally, three separate analyses were conducted, which include descriptive analyses and multivariable regressions. The first dissertation paper examines the scope and prevalence of mental health counseling utilization in Malaysia. Using Andersen’s Health Service Utilization as a conceptual framework, I examine how certain predisposing factors (socio-demographic characteristics), enabling factors (availability of resources), and need factors (mental health symptom severity) are associated with counseling utilization. The second dissertation paper examines suicidal behaviors among Syrian refugee women living in Jordan. Incorporating the Three-Step Theory (3ST) of suicidal behaviors, I examine how psychological pain, connectedness, and postmigration stressors are associated with suicidal behaviors. Lastly, my third dissertation paper examines the scope and prevalence of vicarious posttraumatic growth (VPTG) among service providers working with Syrian refugees in Istanbul, Turkey. Using a constructivist self- development theory, I examine how greater exposure to traumatic material, in addition to having a greater support system, and having greater years of professional experience is associated with higher levels of VPTG. Study results from Malaysia emphasize the need to understand individual and contextual determinants of mental health service use. I hypothesize that refugees and asylum seekers with certain predisposing factors (female, older age, married, higher education, lived longer in Malaysia, registered refugee), have greater enabling factors (easy access to healthcare, larger household income, do not need interpreter services, greater health literacy, and live with greater number of people in household), and have greater need factors (higher PTSD symptoms) will be more likely to attend counseling services. Almost three-quarters (71.89%) of participants surveyed had never attended mental health counseling services. The majority (71.89%) had never attended mental health counseling services, and among those who screened positive for PTSD, only a minority (16.49%) attended counseling services. My hypothesis was partially supported. Participants from Afghanistan and Myanmar were less likely to attend mental health counseling compared to Somalia and other countries (p<0.001). Not having easy access to health facility (OR:0.10, 95% CI:[0.03, 0.32]), needing interpreter services (OR:0.23, 95% CI:[0.07, 0.75]), and higher PC-PTSD scores (OR:0.69, 95% CI:[0.52, 0.91]) was associated with lower odds of counseling attendance. Other determinants of health service use such as gender, marital status, education level, years in Malaysia, registration status, household income, health literacy, and number of people in household did not show significant associations. Study results from Jordan highlight that greater research and public awareness regarding suicidal behaviors is needed among Syrian refugee women. I hypothesize that screening positive for PTSD, social isolation (have no friends or family members available to help), and greater number of postmigration stressors is associated with suicidal behaviors. Approximately one-tenth (9.86%) of participants reported suicidal behaviors (suicidal ideation and/or attempt) in the past 6-months. My hypothesis was partially supported. Screening positive for PTSD (aOR:4.02, 95% CI:[1.33, 12.15]) was associated with increased odds of suicidal behaviors, while having 1 friend or family member available to help when in need (OR:0.31, 95% CI:[0.13, 0.78]) decreased odds of suicidal behaviors. No associations between the number of postmigration stressors and suicidal behaviors were found. Lastly, results from Turkey emphasizes the importance of focusing on service providers wellbeing. I hypothesize that greater exposure to traumatic material, in addition to having a greater support system, and having greater years of professional experience is associated with higher levels of VPTG. Among service providers recruited 44.66% reported moderate-to-high levels of VPTG. My initial hypothesis was partially supported. Moderate/high/severe secondary traumatic stress (aOR:3.98, 95% CI:[1.26, 12.59]), greater social support (aOR:1.05, 95% CI:[1.00, 1.10]), and greater organizational support (OR:1.11, 95% CI:[1.02, 1.20]) was associated with moderate-to-high VPTG. Proportion of clients who disclose trauma, and years in profession did not show significant associations. Mental health utilization, suicidal behaviors, and the well-being of service providers are issues that have all been linked to the mental health and well-being of refugees and asylum-seekers. These topics have been minimally examined among forcibly displaced people living in LMICs. Clinicians and organizations must promote greater awareness of and screening for mental health conditions. Additionally, mental health and suicidal behaviors is often associated with stigma and discrimination, which means that providing basic psychoeducation surrounding mental health, its impact, as well as awareness of services available, and normalizing treatment at the individual and clinic level is essential for increasing engagement of mental health services. To further reduce global mental health disparities and provide equity in mental health care and treatment, future research and psychosocial interventions must prioritize and focus on the well-being of refugees and asylum-seekers living in LMICs.

No description available.

Background: The Tennessee veterans represents 8.3 percent of state’s adult population, these includes the service members from World War II to Iraq and Afghanistan conflicts. Some of the research done on veterans shows that approximately 14% to 16% of U.S. service members deployed suffer from mental health challenges like PTSD or depression and substance abuse. The issue of mental health and substance abuse worsen among veterans populations while transitioning to civil life. The mental health symptoms among 1,239 American veterans assessed online one month prior to the COVID-19 outbreak in the United States through next year shows slight increase in mental health symptoms over time. The proposed study examines the association between veteran status and depression, alcohol use, and smoking in Tennessee. Methods: We used cross-sectional data from the 2021 Behavioral Risk Factor Surveillance System a nationally representative U.S. telephone-based survey of adults aged 18 years and extracted data for Tennessee (n=4,788). Logistic regression analyses were conducted to test the association between coronary artery disease and depression. We controlled for past month income, race/ethnicity, educational status, gender, and age. Results: Overall, among U.S. military veterans 23.7% (n=145) were diagnosed with depression, 46.6% consumed alcohol in the last 30 days, while 15.2% (n=93) smoked cigarettes within the last 30 days. U.S military veterans status (OR=1.40, 95% CI, 1.12, 1.74) along with low income (OR=2.21, 95% CI, 1.91, 2.55) and female gender (OR=2.07, 95% CI, 1.78, 2.41) was significantly associated with depression. U.S military veteran status was not associated with alcohol use or smoking. Conclusion: The results implicate that the veterans in Tennessee are on higher risks of depression and alcohol consumption than non-veterans. Findings highlight the need of ongoing treatment and social support for the veterans population in Tennessee. Additional research is needed to understand the type of treatment and social support for this population. Keywords: Coronary Heart Disease, Mental Health Disorders, Health disparities in Tennessee

Despite high rates of suicide and mental health concerns (Duldulao, Takeuchi, & Hong, 2009; Kisch, Leino, & Wilverman, 2005; Lee, Park, Lee, Oh, Choi, & Oh, 2018; World Health Organization, 2019), many Asian Americans including Koreans and Korean Americans do not seek mental health services (Lam & Zane, 2004; Lee, Hanner, Cho, Han, & Kim, 2008; Markus & Kitayama, 1991; Sue, Cheng, Saad, & Chu, 2012). Especially for Koreans and Korean Americans, stigma (Masuda & Latzman, 2011) as well as cultural values (e.g., Cheng, Leong, & Geist, 1993; Cheong & Snowden, 1990; Kim & Omizo, 2003; Tracey, Leong, & Glidden, 1986) can prevent them from seeking appropriate services. The current study compares Korean, Korean American, and non-Korean emerging and young adults’ mental health literacy (Jorm, Korten, Jacomb, Christensen, Rodgers, & Pollitt, 1997), specifically mental health knowledge, confidence in finding appropriate mental health services, and attitudes towards mental disorders and treatment. A pilot study was conducted to tailor the Mental Health Literacy Scale (O’Connor & Casey, 2015) to answer the main research questions and examine internal consistency and validity. Analysis of variance (ANOVA) was used to assess the differences among the sociocultural groups (i.e., Koreans, Korean Americans, and non-Asians) and investigate individual and contextual influences (e.g., age, gender, citizenship). The results demonstrated that (1) non-Asians have significantly higher mental health knowledge scores, higher self-efficacy, and less negative attitudes towards mental disorders compared to Koreans and Korean Americans and (2) there were no significant differences in the scores between Koreans and Korean Americans. The discussion section describes the importance of enhancing mental health literacy and increasing help seeking behavior for Koreans and Korean Americans and suggests cultural factors to consider in creating culturally appropriate outreach programs.

Aim: To determine if a significant relationship exists between a) nurse-driven interventions to foster collaborative psychiatric and oncology care and b) higher rates of cancer treatment adherence and lower healthcare utilization rates in patients with serious mental illness (SMI) and cancer. Background: It is not uncommon for patients with SMI to suffer from treatment noncompliance and present in the acute care setting, such as the emergency department. Patients with cancer and SMI pose a unique challenge to nurses and providers due to the psychological effect of a cancer diagnosis as well as side effects experienced from psychotropic medications and oncology treatments alike. As a result, these patients are less likely to maintain cancer treatment regimens and present with advances stages of cancer in the acute care setting. Methods: An extensive electronic literature search in the CINAHL Plus and APA PsycINFO databases was completed and included the keywords: cancer, neoplasms, carcinoma, serious mental illness, chronic mental illness, mental disorders, mental disorders, chronic, psychiatric illness, psychiatric disability, cognitive behavioral therap*, intervention*, mindful*, and mental health. Inclusion criteria included: published in the years 2012-2022. The available literature was carefully examined for interventions performed with SMI and cancer for ultimate results to be finalized as a written report. Significance: The results of this research can optimize healthcare and prognosis for the population of mental health patients with cancer and also reduce costs to the healthcare system. Conclusion: The 10 studies reviewed indicated that collaborative psychiatric-oncology care with specific Registered Nurse (RN)-led interventions, such as medication management programs and behavioral counseling, was associated with increased rates of cancer treatment adherence and lower rates of healthcare utilization. Conclusions were based on data collected in cohort studies, randomized control trials, pre- and post-intervention assessments, and clinic data from quality improvement projects. More research is needed to explore the implementation of collaborative care practices.

No description available.

No description available.

No description available.

We are in a new global era, framed and shaped by migration and record movements across borders. The intersection of migration, mental health, and psychosocial wellbeing represents an increasingly important matter in the humanitarian space. Global rates of migration are at an all-time high, with internal and cross-border migration hitting record figures (United Nations Department of Economic and Social Affairs, Population Division, 2020). Mexico is a country that has been particularly affected by migration, as a top country of transit, as well as destination for migrants and asylum-seekers from the Americas and across the globe. The rise of displaced people traveling to Mexico and the United States, in combination with limited protection and legal support for migrants, has resulted in an unprecedented situation requiring attention. Population displacement results from an array of push factors, including political instability, climate degradation, natural disasters, and economic/physical insecurity. As growing numbers of people migrate to and through Mexico in search of protection and improvements in livelihoods, it is crucial to consider gaps in access to support services for migrants and asylum-seekers. Access to health care has long been a challenge for migrant populations in Mexico (Infante, 2022), and in particular, barriers have been reported in relation to Mental Health and Psychosocial Support (MHPSS) for people migrating while seeking asylum further North (Allande, 2022). Thus, there exists a need for the provision of improved and adapted MHPSS programs for migrants in Mexico, with particular attention to those from outside of Mexico seeking asylum in the United States. Working in collaboration with local partners, this Integrated Learning Experience (ILE) summarizes findings from a multi-stage exploratory assessment. The overarching goal of this ILE was to identify opportunities for improving the design and implementation of MHPSS for migrant populations in Mexico. To do so, this research focused on addressing three specific aims: identify major gaps and challenges in delivering MHPSS services from the perspectives of practitioners and scholars (Aim 1); assess perceptions of existing MHPSS services from the perspective of intended users through in-depth inquiry with migrant communities (Aim 2); and, map barriers and facilitators to accessing MHPSS services as well as co-creating implementation strategies, tools and key recommendations through participatory workshops with key actors (Aim 3). The specific research methods utilized in this assessment included: A) synthesis of 3 years of survey data gathered from service providers, along with key informant interviews (KIIs) with service providers to identify existing programs, gaps, and challenges; B) focus group discussions with migrant populations combined with ethnographic observations to assess support and how they are perceived, and C) participatory workshops with key actors to co-create implementation strategies to improve supports from a systems perspective. By mapping existing MHPSS supports in key locations and engaging with different stakeholders through participatory methods, this ILE presents a systematic, conceptual approach to identify leverage points for improvements in programs that fit the unique situation and lived experiences of people on the move. The final recommendations outline practical steps to promote more coherent and comprehensive approaches to MHPSS programming while recognizing and responding to overlapping risks of violence, discrimination, and other challenges this population may face. Key takeaways reveal overall shortages in availability of services, and gaps in information-sharing and coordination. Most importantly, findings show a cultural disconnect with many MHPSS programs, calling for a rethink of how to design and implement services in a manner that better fit the realities and preferences of migrant communities. Ways forward include promoting cultural humility, community engagement, listening, and promoting agency in order to strengthen MHPSS practices that are grounded in and sensitive to the views of those migrating.