Interprofessional collaboration among school-based and community-based mental health providers in children's mental has been studied in relation to specific providers and as part of program evaluation; however, limited information exists as to how to overcome barriers to collaborative relationships. This study describes the experiences of school and community mental health service providers and those who supervise them. Using phenomenological methodology, three focus-group interview transcripts were analyzed by identifying recurrent themes relevant to the experience of collaboration from school and community providers' perspectives. Although participants viewed aspects of collaboration positively, barriers frequently interfered with collaborative relationships. Support for collaboration from state, district or organization administration was considered necessary for widespread collaboration across settings. To reduce time constraints on existing school staff, school-based professionals suggested it may be necessary to employ additional staff to manage collaborative relationships. Participants' ideas for funding included cutting costs, reducing risks, and grant writing. Jointly developing procedures, increasing accessibility by having services available within the school setting, and collecting outcome data regularly to share with stakeholders were discussed. Understanding the experiences of collaboration among school and community mental health providers has the potential to ignite social change by helping schools and community agencies overcome barriers to collaboration through improved coordination of services for children with unmet mental health needs.

There are negative personal, psychological, and professional implications of working with individuals who have suffered from trauma, to include secondary trauma. A significant research gap exists in regard to how secondary trauma bears on psychosocial assistants (PAs). Bukavu, in the Democratic Republic of Congo (DRC), has a shortage of trained and licensed mental health providers, and as a result, mental health services have been shifted to PAs. Using Bandura's social cognitive theory and Orem's theory of self-care, this qualitative phenomenological study explored the lived experiences of secondary trauma, through face to face interviews with 13 PAs in Bukavu. The collected data was analyzed using Bryman's four stages of coding. This study found that PAs experienced symptoms of secondary trauma. In talking about their experiences, the themes that emerged included personal changes, perseverance, fear and insecurity, suffering, "thinking too much," nervousness, feeling lost, conflict of compassion, hopelessness, helplessness, religion, faith, the role of God and conflict. PAs had limited knowledge of secondary trauma, its effects and how to manage it. Loneliness, strength, faith, time, money and self-protection, were prominent themes around PAs' discussion of their training and experiences with coping. The findings of this research add to the understanding of secondary trauma of these PAs and may influence the personal and professional wellbeing of PAs through gaining knowledge about their experiences. Understanding secondary trauma in PAs may impact social change in the DRC through influencing the structuring of policies and delivery of mental health services to protect workers and beneficiaries.

Mexican Americans, the largest Hispanic subgroup in the United States, tend to underuse mental health services. Grounded in Andersen's behavioral model of health services use, the purpose of this nonexperimental study was to examine the likelihood of birth country, education, income, and insurance predicting which respondents would report seeking mental health services to treat depression. The Mini International Neuropsychiatric Interview was used to diagnose depression in 203 Mexican Americans whose data was archived from the primary study. This archived data was analyzed within this study. The results of the 2 x 2 chi-square tests of independence indicated a significant association between a person's birth country and the likelihood that a person will seek mental health treatment, with U.S.-born participants more likely to seek mental health treatment than foreign-born participants. There were no significant bivariate associations found between education, income, or insurance and seeking mental health treatment. The full model containing the 4 independent variables was statistically significant per the results of the binary logistic regression analysis. This finding indicates that the model reliably distinguished between respondents who reported seeking and not seeking mental health treatment. The results of the binary logistic regression analysis indicated education was the only independent variable that made a uniquely significant contribution to the model, with participants with 12 years or more of education more likely to seek mental health treatment. The implications for positive social change include the potential to provide communities and health care providers knowledge of the factors that influence whether Mexican Americans with depression access mental health.

Traditionally, mental health professionals have provided psychotherapeutic services through face-to-face sessions. As the Internet has become an increasingly important part of individuals' personal and professional lives, psychologists and clients have used this medium to expand access to psychotherapy. The purpose of this quantitative correlational design was to investigate whether demographic variables and the personality traits of extroversion/introversion (E/I), as assessed by the Big Five Inventory, predicted clients' preferences for a specific method of administered psychotherapy. The theoretical framework for this study was social information processing through computer-mediated communication. An online survey site was used to assist in survey design and data collection, and 301 individuals participated in the study. Results of the Pearson correlation indicated that age was negatively correlated with use of online therapy (p = .038). The variables of region, race, and E/I had no statistically significant effect on the use of online versus in-person therapy (all p values > .05). Findings reflected larger social trends that decisions to seek online therapy fall along lines of diversity related to age and technological knowledge. Recommendations include engaging older patients in opportunities for participating in online therapeutic services, as well as further research on the relationship between cultural diversity and online therapy. These results can inform practitioners and the community about the importance of expanding access to psychotherapeutic services for individuals who need them, which will in turn be an important component of positive social change.

Stigmatizing mental illness involves negative perceptions or attitudes about mental illness and the individuals who have mental illness, generating problematic consequences for both the general population and for people with mental illness. The theory of multiple intelligences proposes that intelligence includes skills and abilities in any area; emotional intelligence (EI), therefore, includes an individual's ability to identify, interpret, and regulate emotions and emotional responses. This study was designed to evaluate level of familiarity with mental illness as a potential predictor for stigmatizing mental illness, to assist in evaluating the relationship between stigmatizing mental illness and EI. The study was specifically designed to determine whether having higher EI is associated with a decreased likelihood to stigmatize mental illness, and whether increased familiarity is associated with greater EI and a decreased likelihood to stigmatize mental illness. It used bivariate correlations and hierarchical regression analyses, respectively, using data collected from a demographic questionnaire, the TEIQue-SF, the AQ-27, and the LOF. The target population consisted of emergency department (ED) staff (N = 43). Findings suggested that EI and mental illness stigma are correlated (r = -.514, p < .001) and that there is a significant interaction between EI and level of familiarity with mental illness (R2 = .269, F(3, 38) = 4.653, p = .007). ED staff are on the frontline of healthcare and serve as a gateway to systems of care and treatment; as a result, this study's findings are important and are intended to inform healthcare and stigma-combating organizations of factors that can improve the sensitivity and quality of care for individuals with mental illness who admit to healthcare systems.

Medical interpreter services will be essential for developing and implementing culturally relevant interventions and treatment for limited English proficiency (LEP) populations. This study sought to identify the possible risks or protective factors that may be associated with vicarious traumatization (VT) or vicarious posttraumatic growth among medical interpreters in behavioral health settings. A 2-step cluster analysis was conducted yielding 2 distinct groupings of medical interpreters (Subtype 1, n = 73; Subtype 2, n = 101). The most important predictor determining the 2 subtypes was whether the participant had a personal history of trauma. In addition, there were significant differences between the 2 subtypes among the following variables: Trauma and Attachment Belief Scale T-scores of VT; years as a medical interpreter; years as a behavioral health medical interpreter; level of education as it relates to interpreting; personal history of trauma; personal or family history similar to any of the trauma survivors served in the past year; specific mental health training; sought personal therapy related to exposure to traumatic material from work environment; current relationship status; race; and whether spoken, sign, or both spoken and sign language interpretation was provided. The results of this quantitative study further support the constructivist self-development theory where VT is the result of the accumulated effects of repeated exposure to trauma material in combination with the person of the provider. Understanding these risk and protective factors will continue to support the provision of effective treatment of LEP individuals in behavioral health settings and the ongoing professional development of behavioral health medical interpreters.

There has been an increase in the number of individuals with mental illness being housed in correctional facilities over the last 50 years. In this study, the length of pretrial detention was compared for inmates who have a mental illness and are compliant with psychiatric medications, inmates who have a mental illness and are noncompliant or not prescribed psychiatric medication, and inmates with no mental illness. I also examined if inmates who have a mental illness have less severe charges and if there was a difference in the classification of mental health diagnoses for inmates who are and are not compliant with psychiatric medications. The study used the closed charts of 427 male inmates from 1 county jail in New Jersey from the year 2016. The theoretical foundation of this study is Abraham Maslow's hierarchy of needs, as it is believed that the basic physiological and safety needs should be met in order to provide mental health treatment. A combination 1-way analyses of variance (ANOVA) and chi-squared analysis was used to examine the data. It was concluded that inmates with mental illness who are medication compliant are incarcerated significantly longer pretrial than inmates with no mental illness. It was also found that there was a difference in the types of charges received between those with and without a mental illness. Lastly, the study found that there was no significant difference between each of the classifications of mental illness when comparing inmates with mental illness who are and are not compliant with psychiatric medications. The implication for positive social change is the benefits to the inmates with mental illness and the correctional facilities, as it confirms that inmates with a mental illness require more tailored and treatment specific services for a longer period of time.

This DNP project addresses the healthcare issue of intimate partner, domestic, and sexual violence (IPDSV), its impact on survivors, and reducing the potential for retraumatization by those who care for them in the clinical, behavioral, and social settings. Trauma-informed care interventions are designed to address the sequelae of trauma, promote recovery, and support resilience. Since IPDSV is a global health issue, supporting cultural needs of all clients is an essential aspect of trauma-informed care. This project was guided by a central research question that examined if trauma-informed, culturally competent curriculum be viewed by community stakeholders as an appropriate intervention for the education of their workforce in preventing survivor retraumatization. The framework for this project was informed by the sanctuary model, the 4 major tenets of Leininger's theory of culture care diversity and universality, and the 5 constructs of cultural competence by Campinha-Bacote. The focal site was a domestic violence shelter that provides care for a multitude of culturally diverse trauma survivors. Demographic data were collected, and a descriptive analysis performed to determine the diversity and needs of the residents. These data were then used to develop a culturally competent program using trauma-informed principles to prevent the effects of recidivism, and to promote healing, empowerment, and resilience in survivors.

The mental health literacy (MHL) rates of Christian clergy in the United States remains underinvestigated in the current literature. This gap of knowledge is problematic for the large numbers of individuals with mental illness who seek assistance from clergy and may receive inadequate care for their concerns. As theoretically designated by the behavioral models of health care and MHL research, denomination-type, educational variables, and demographic characteristics were investigated as potential predictors of MHL. A sample of 238 Christian clergy from throughout the United States completed the web-based Mental Health Literacy Scale and demographic questionnaire. Results of analysis of variance (ANOVA) revealed no significant differences among MHL scores of Evangelical Protestant, Mainline Protestant, Catholic, and Historically Black Protestant groups. Results of the multiple linear regressions showed that number of years of postsecondary school, degree-type, age, and geographical location were not significant predictors of MHL scores. Higher numbers of clinical MH training courses and female gender did significantly predict higher levels of MHL scores. The findings provided the first parametric measure of a diverse, national sample of Christian clergy and indicated a need for increasing MHL trainings. Results also provided counselors and counselor educators with information useful for initiating and modeling interprofessional trainings, collaborations, and referral partnerships with clergy who currently serve as front-line mental health workers to millions of U.S. residents. The results may also inform social justice initiatives to reduce mental health care disparities in underserved populations.

Improving Quality-of-Life in Older Adults with Depression and Diabetes through Medication Compliance Education by Valreen Hinds-Beharrie MSN, Adelphi University, 1997 BSN, Adelphi University, 1986 Project Submitted in Partial Fulfillment of the Requirement for the Degree of Doctor of Nursing Practice Walden University March 2016 Diabetes and depression are prevalent diseases that cause morbidity and mortality. Diabetes is a heterogeneous metabolic disease in which hypoglycemia is a central feature. Depression is associated with increased counter-regulatory, hormone release, and alteration in glucose transport function. Depression occurs in some individuals with diabetes and is associated with poor metabolic control, inadequate control of diet, and poor adherence to medication that can decrease quality of life. The prevalence of depression in Type 2 diabetes mellitus patients is significantly higher in the over 55-year-old population than in the general public. The purpose of this quality improvement project was to assess whether a medication compliance program would improve the quality of life of older adults diagnosed with depression and diabetes. Orem's self-care deficit theory provided a theoretical framework to guide and assist the patient with depression and diabetes to meet self-management regimen. The project question investigated whether a compliance education program could improve the quality of life of adults with depression and diabetes. A convenience sample of 28 patients diagnosed with depression and diabetes participated in the program. Outcome data were collected pre and post-intervention via the World Health Organization's Quality of Life Questionnaire and calculated using percentage difference, revealing an improvement in quality of life. There were compelling improvements in physical health (+28.5%), social relationships (+32.3%), and environment (+25%). Measurable improvements were also seen in physical health (+15.1) and in general health (+3.6). These findings may serve to influence practice and can lead to positive social change in this population by decreasing the risk of complications and improve the well-being of these dual diagnosis patients.