Individuals exposed adverse childhood experiences (ACEs) are at increased risk of developing chronic illnesses in adulthood including heart disease, cancer, diabetes, and chronic pain. A relationship between ACEs and health risk factors contributing to chronic disease such as smoking, obesity, and sedentary lifestyle has also been established in prior literature. There is evidence that higher that individuals in forensic inpatient mental health samples are disproportionally exposed to ACEs, which may increase odds of chronic disease development. Despite this evidence, little research has examined the prevalence of ACEs and relationships between ACEs and chronic health conditions and risky health behaviors in this population. This study evaluated these variables using archival data collected as part of a large interdisciplinary study from a forensic psychiatric facility. A list of clients (N=182) meeting inclusion criteria was randomly generated and a comprehensive record review was used to ascertain ACE scores and rates of health-risk behaviors and chronic conditions. Findings offered support for increased rates of childhood adversity and a significant relationship between ACE scores and health-risk behaviors within a forensic inpatient mental health population. However, relationships between ACEs and chronic illnesses and health-risk behaviors and chronic illnesses failed to reach significance. The lack of significance in these relationships suggests that ACEs are less singularly predictive of chronic illness within this population and instead different factors may drive the development of chronic illness.

The purpose of this study was to test the hypothesis that the hearing distressing voices simulation training, Developing Empathy for the Lived Experience of Psychiatric Disability: A Simulation of Hearing Distressing Voices (HDVS), developed by Patricia E. Deegan, Ph.D., will affect counseling students’ empathy for clients diagnosed with schizophrenia, as measured by the Jefferson Scale of Empathy – Health Professions Students version (JSE-HPS). The experimental design was a quasi-experimental, one-group, pre-test/ post-test, and the Jefferson Scale of Empathy – Health Professions Students version was used to measure empathy. A total of 55 participants were drawn from a convenience sample of master’s counseling students from CACREP-accredited programs in southern Louisiana and Chicago, Illinois. A two tailed, paired samples t-test revealed that there was a significant difference (pM=116.11, SD=9.76) and post-test empathy scores (M=121.85, SD=8.9). This study suggests the HVDS is an effective tool to assist counseling students with developing empathy, decreasing stigmatizing attitudes, and avoiding disempowerment and marginalization within the counseling relationship.

The purpose of this study was to explore the perceptions and experiences of people living with serious mental illness (SMI) receiving housing assistance. A qualitative method was used to interview five adults with SMI living in a supported housing model. An Ecological Systems Theory (EST) was used as the theoretical orientation for the study. The major themes related to success of the supported housing that emerged were independence, involvement of owners, bonds with tenants, having access and means to resources, and positive engagement in well-being. No themes of unmet needs were presented. The study concluded people with SMI in need of housing will benefit by being in a supported housing model such as the one in the study. The two main limitations of the study are small sample size and limits in generalizing beyond the one location.

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Healthcare resources are especially limited in rural regions of the US. The lack of Primary Care Providers (PCPs) and mental/behavioral health services is problematic, as there are high rates of behavioral and medical concerns within rural populations. Special populations, such as rural persons with Serious Mental Illness (SMI), are medically complex and represent a vulnerable and underserved population. Healthcare outcomes for persons with SMI are poor compared to the general population and commonly lead to premature death. Various barriers prevent this population from accessing optimal healthcare, especially in rural areas, due to negative perceptions/stigma, a lack of understanding from PCPs, and a shortage of resources in general. The current study aimed to determine the extent of mental health training that rural PCPs receive regarding patients with SMI, as well as to evaluate their perceptions, knowledge, and experiences with these patients and understand providers’ perceptions regarding rates of patients with SMI who present to primary care clinics in rural settings. The current study used a sample of rural primary care providers (N = 90) , surveyed via USPS mail. Results indicated significant differences in reported mental health training among providers from different disciplines. Greater reported mental health training significantly predicted lower levels of stigma, more correctly identified medical conditions comorbid with SMI, and greater reported comfort and confidence in treating patients with SMI. Providers reported differences in the number of patients with and without SMI seen in rural clinics. Implications for these findings are discussed.

Indiana University-Purdue University Indianapolis (IUPUI) / The criminalization of mental illness has drawn and kept a disproportionate number of people living with mental illness in jails and prisons across the United States. The criminal legal system is ill-equipped or unequipped to provide meaningful mental health care. Police often serve as gatekeepers to the criminal legal system in the midst of encounters involving people living with serious mental illness. The literature that examines police decision-making amid these highly discretionary encounters has been primarily situated in post-positivist, quantitative methodologies focused on police perspectives. There is a dearth of research with the direct involvement of people living with serious mental illness that employs more advanced qualitative methodologies. The purpose of this study was to understand the lived experience of police encounters from the perspective of people living with serious mental illness through multi-level analysis of the interpersonal and structural contexts which underpin these encounters. This critical phenomenological study used interpretative phenomenological analysis as process. A sample of 16 adults were recruited using purposive and snowball sampling and completed semi-structured interviews. The findings reported two descriptive areas for participants—aspects of serious mental illness and contemplations of power. The findings also included the interpretive analysis organized around six themes that emerged regarding the lived experience of police encounters: (a) significant context, to include serious mental illness, was made invisible, (b) the carceral response to serious mental illness and interpersonal issues, (c) law enforcement’s power to force submission, (d) facets of escalation, (e) law enforcement encounters lacked essential care, and (f) law enforcement encounters served as a microcosm of the criminal legal system. The implications of the study’s findings on police encounters as they are currently framed in the largely post-positivist, quantitative body of research are discussed. In addition, the current wave of national police response models and reform are considered and connected to implications for social work practice. Finally, culminating in the findings’ implications for a growing edge of critical phenomenology that incorporates intersectionality and disciplinary power and the central role of an abolition feminist praxis at the nexus of mental health, crisis response, and collective care.

Supporting the physical activity of clients with serious mental illness in Prague Abstract The aim of this diploma thesis was how social workers perceive the possibilities of supporting regular physical activity of clients with serious mental illness. The research part was carried out using a questionnaire survey conducted among social services workers focused on the care of mental illness and operating in Prague. The study involved 37 respondents, among whom there was an equal representation of those who work within multidisciplinary teams (CDZ or facilities of this type, where they are provided together with social services and health services), as well as those who work in facilities providing only social services. Through a questionnaire survey, it was found that in multidisciplinary teams, where the health services component is also represented, more attention is paid to the support of appropriate regular physical activity in these types of facilities. Keywords: serious mental illness, social work, regular physical activity

People with serious mental illnesses (SMIs) (e.g., schizophrenia, major depressive disorder, bipolar disorder) receive inadequate medical care, which is associated with high rates of avoidable morbidity and premature mortality. Assertive Community Treatment (ACT) is an evidence-based service delivery model that provides intensive mental and social health support to clients with SMI. It has been suggested that ACT should provide primary care services to address client physical health, however, initiatives towards this and their implications are not well understood. I used a case study approach and semi-structured interviews to explore five ACT teams in the Ottawa region to discover team members’ mental models of primary care, relationships with external primary care providers, and the perceived impact COVID-19 has had on these mental models. I used Shared Mental Model (SMM) theory to frame data collection and a thematic analysis. The results showed that ACT team members similarly perceived primary care as important for the holistic health of their clients. They described ACT’s psychosocial scope and how they support clients’ access to external primary care services and their work to mitigate barriers. Teams did not share mental models about the basic primary care services they provided or which roles delivered them, due to differences in context and team members’ comfort. Team members also did not share beliefs about the future of ACT and primary care integration. Finally, the COVID-19 pandemic changed and challenged primary care delivery, with beliefs becoming more negative overall. This thesis provides insight into how primary care could be delivered to ACT clients and where challenges and improvements can be addressed.

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