Suchergebnisse

Schizophrenia is a leading cause of disability and health expenditure worldwide and is associated with homelessness, substance use, familial and social isolation, unemployment, involvement with the criminal justice system, stigma, and excess mortality. Prevention may be feasible through intervention with help-seeking "clinical high-risk" youth with early symptoms of psychosis. A social work approach to psychosis prevention would build upon initial evidence that prevention is effective for this population and would add cross-disciplinary coordination of services, mobilization of community resources, and expertise in psychosocial interventions. Recent governmental funding priorities and policies have increasingly focused on early intervention for psychosis, making rapid change feasible. This substantial potential for change, the massive savings in the quality of lives that would accrue, and the broad impact across social work domains are consistent with the goals of the American Academy of Social Work and Social Welfare's Grand Challenges Initiative.

Abstract
Police violence is reportedly common among those diagnosed with mental disorders characterized by the presence of psychotic symptoms or pronounced emotional lability. Despite the perception that people with mental illness are disproportionately mistreated by the police, there is relatively little empirical research on this topic. A cross-sectional general population survey was administered online in 2017 to 1,000 adults in two eastern U.S. cities to examine the relationship between police violence exposure, mental disorders, and crime involvement. Results from hierarchical logistic regression and mediation analyses revealed that a range of mental health conditions are broadly associated with elevated risk for police violence exposure. Individuals with severe mental illness are more likely than the general population to be physically victimized by police, regardless of their involvement in criminal activities. Most of the excess risk of police violence exposure related to common psychiatric diagnoses was explained by confounding factors including crime involvement. However, crime involvement may necessitate more police contact, but does not necessarily justify victimization or excessive force (particularly sexual and psychological violence). Findings support the need for adequate training for police officers on how to safely interact with people with mental health conditions, particularly severe mental illness.

Objective: Psychotic experiences are associated with psychiatric treatment utilization, though findings have not been entirely consistent. Furthermore, it is unclear how psychotic experiences relate to specific types of psychiatric treatment, and whether mental illness moderates these associations. Methods: In total, 1,036 adult residents of Buenos Aires were recruited through convenience sampling in public places. Multivariable logistic regression models examined the associations between psychotic experiences and psychiatric treatment, adjusted for age, sex and education. Analyses were then stratified by diagnosis of mental illness. Results: Approximately 17.95% ( N = 186) of the sample reported at least one psychotic experience over the past week, about 22.39% ( N = 232) of the sample was receiving some psychiatric or psychological treatment and 8.59% ( N = 89) was receiving psychopharmacological treatment. In the total sample, psychotic experiences were associated with greater odds of being in psychiatric/psychological treatment (adjusted odds ratio (AOR): 1.52; 95% confidence interval (CI): 1.05–2.21) and psychopharmacological treatment (AOR: 2.49; 95% CI: 1.52–4.09), adjusted for age, sex and education. Mental illness did not moderate the association between psychotic experiences and psychiatric/psychological treatment, but did moderate the association between psychotic experiences and psychopharmacological treatment. Among people with mental disorders, psychotic experiences were associated with greater odds of receiving psychopharmacological treatment (AOR: 14.63; 95% CI: 1.73–123.45) versus people without mental disorders (AOR: 1.75; 95% CI: 0.98–3.15). Conclusion: Psychotic experiences are associated with psychiatric treatment utilization, particularly psychopharmacological treatment among people with a co-occurring mental illnesses. Translational research should explore the utility of psychosis screens in assessing need for medication or clinical responsiveness to medications.

Abstract. Background: Self-esteem is a major contributor to risk for repeated suicide attempts. Prior research has shown that awareness of stigma is associated with reduced self-esteem among people with mental illness. No prior studies have examined the association between self-esteem and stereotype awareness among individuals with past suicide attempts. Aims: To understand the relationship between stereotype awareness and self-esteem among young adults who have and have not attempted suicide. Method: Computerized surveys were administered to college students (N = 637). Linear regression analyses were used to test associations between self-esteem and stereotype awareness, attempt history, and their interaction. Results: There was a significant stereotype awareness by attempt interaction (β = –.74, p = .006) in the regression analysis. The interaction was explained by a stronger negative association between stereotype awareness and self-esteem among individuals with past suicide attempts (β = –.50, p = .013) compared with those without attempts (β = –.09, p = .037). Conclusion: Stigma is associated with lower self-esteem within this high-functioning sample of young adults with histories of suicide attempts. Alleviating the impact of stigma at the individual (clinical) or community (public health) levels may improve self-esteem among this high-risk population, which could potentially influence subsequent suicide risk.

Purpose Social workers are employed in a broad range of community settings, in which they may be able to identify youth with emerging psychotic symptoms and facilitate connection to specialized services. Methods: This randomized controlled trial tested the efficacy of a training intervention for social workers ( N = 959) intended to increase the volume of referrals and rate of successful referrals to specialized early psychosis services. Results: During the 2-year study period, referrals to the early intervention program nearly doubled, t (df = 11) = 5.46, p < 0.001. Additionally, the rate of successful referrals was greater among social workers who received the active training (41.7%) compared to the other referral sources (19.2%), X2 (df = 1, n = 311) = 3.69, p = 0.055. Conclusions: The active training was associated with a marginally greater rate of successful referrals. Overall referrals increased greatly during the training period although this could not be linked to specific participants, suggesting contamination effects may have increased community awareness of early intervention services.