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Home Foreclosure, Health, and Mental Health: A Systematic Review of Individual, Aggregate, and Contextual Associations

July 1, 2015 Comments off

Home Foreclosure, Health, and Mental Health: A Systematic Review of Individual, Aggregate, and Contextual Associations
Source: PLoS ONE

Background
The U.S. foreclosure crisis intensified markedly during the Great Recession of 2007-09, and currently an estimated five percent of U.S. residential properties are more than 90 days past due or in the process of foreclosure. Yet there has been no systematic assessment of the effects of foreclosure on health and mental health.

Methods and Findings
I applied systematic search terms to PubMed and PsycINFO to identify quantitative or qualitative studies about the relationship between home foreclosure and health or mental health. After screening the titles and abstracts of 930 publications and reviewing the full text of 76 articles, dissertations, and other reports, I identified 42 publications representing 35 unique studies about foreclosure, health, and mental health. The majority of studies (32 [91%]) concluded that foreclosure had adverse effects on health or mental health, while three studies yielded null or mixed findings. Only two studies examined the extent to which foreclosure may have disproportionate impacts on ethnic or racial minority populations.

Conclusions
Home foreclosure adversely affects health and mental health through channels operating at multiple levels: at the individual level, the stress of personally experiencing foreclosure was associated with worsened mental health and adverse health behaviors, which were in turn linked to poorer health status; at the community level, increasing degradation of the neighborhood environment had indirect, cross-level adverse effects on health and mental health. Early intervention may be able to prevent acute economic shocks from eventually developing into the chronic stress of foreclosure, with all of the attendant benefits this implies for health and mental health status. Programs designed to encourage early return of foreclosed properties back into productive use may have similar health and mental health benefits.

Psychological Testing in the Service of Disability Determination (2015)

June 29, 2015 Comments off

Psychological Testing in the Service of Disability Determination (2015) (PDF)
Source: Institute of Medicine

The United States Social Security Administration (SSA) administers two disability programs: Social Security Disability Insurance (SSDI), for disabled individuals, and their dependent family members, who have worked and contributed to the Social Security trust funds, and Supplemental Security Income (SSSI), which is a means-tested program based on income and financial assets for adults aged 65 years or older and disabled adults and children. Both programs require that claimants have a disability and meet specific medical criteria in order to qualify for benefits. SSA establishes the presence of a medically-determined impairment in individuals with mental disorders other than intellectual disability through the use of standard diagnostic criteria, which include symptoms and signs. These impairments are established largely on reports of signs and symptoms of impairment and functional limitation.

Psychological Testing in the Service of Disability Determination considers the use of psychological tests in evaluating disability claims submitted to the SSA. This report critically reviews selected psychological tests, including symptom validity tests, that could contribute to SSA disability determinations. The report discusses the possible uses of such tests and their contribution to disability determinations. Psychological Testing in the Service of Disability Determination discusses testing norms, qualifications for administration of tests, administration of tests, and reporting results. The recommendations of this report will help SSA improve the consistency and accuracy of disability determination in certain cases.

The Processing and Treatment of Mentally Ill Persons in the Criminal Justice System: A Scan of Practice and Background Analysis

June 24, 2015 Comments off

The Processing and Treatment of Mentally Ill Persons in the Criminal Justice System: A Scan of Practice and Background Analysis
Source: Urban Institute

Mentally ill offenders possess a unique set of circumstances and needs. However, all too often, they cycle through the criminal justice system without appropriate care to address their mental health. Their recurring involvement in the criminal justice system is a pressing concern. This report provides a national landscape on the processing and treatment of mentally ill individuals in the criminal justice system. It also highlights challenges involved in the reintegration of mentally ill offenders into society, the diversity of policies and protocols in state statutes to address such challenges, and promising criminal justice interventions for mentally ill offenders.

A look at violence in the workplace against psychiatric aides and psychiatric technicians

June 23, 2015 Comments off

A look at violence in the workplace against psychiatric aides and psychiatric technicians
Source: Bureau of Labor Statistics

Psychiatric aides and technicians are experiencing high rates of nonfatal occupational injury and illness due to violence in the workplace by patients. For psychiatric aides, the rate is 69 times higher than the national rate of violence in the workplace, and for psychiatric technicians it is 38 times higher. The rates for these two occupations were different from each other even though psychiatric aides and technicians have similar job environments and duties. This article analyzes the similarities and differences of these occupations, gives a brief overview of psychiatric practices in the United States, and looks at areas where more research could be conducted to help prevent future injuries and illnesses for people in these occupations.

Health-related factors predict return to custody in a large cohort of ex-prisoners: new approaches to predicting re-incarceration

June 22, 2015 Comments off

Health-related factors predict return to custody in a large cohort of ex-prisoners: new approaches to predicting re-incarceration
Source: Health and Justice

Background
Numerous poor health outcomes have been documented in the world’s large and growing population of prisoners and ex-prisoners. Repeat justice involvement and incarceration is normative for ex-prisoners in most countries. This study aimed to identify important health-related predictors of re-incarceration and to quantify their contribution to predicting re-incarceration.

Methods
Participants were 1 325 adult ex-prisoners in Queensland, Australia. We developed a multivariate Cox proportional hazards model for re-incarceration including health-related covariates from a pre-release survey.

Results
In addition to well-established risk factors (criminal history, drug-related sentence, younger age, male gender and Indigenous ethnicity), several health-related variables were important risk factors for re-incarceration in multivariate analyses, including risky use of cannabis (hazard ratio 1.27; 95% confidence interval 1.06, 1.51), amphetamines (HR 1.20; 95%CI 0.99, 1.46) or opioids (HR 1.33; 95%CI 1.08, 1.63) prior to incarceration, central nervous system medication prescription (HR 1.28; 95%CI 1.06, 1.54), reporting that maintaining physical health post-release was not important (HR 1.52; 95%CI 0.98, 2.36) and poverty prior to incarceration (HR 1.24; 95%CI 1.02, 1.52). Sedentary behaviour (HR 0.82; 95%CI 0.68, 1.00), obesity (HR 0.81; 95%CI 0.64, 1.02), multiple lifetime chronic illnesses (HR 0.85; 95%CI 0.71, 1.01) and a history of self-harm (HR 0.72; 95%CI 0.59, 0.88) were associated with a reduced risk of re-incarceration. Inclusion of health-related variables in the model improved prediction of re-incarceration compared to a model with only demographic and criminal justice predictors, leading to an increase in adjusted proportion of explained variation of 0.051 (95%CI 0.031, 0.107).

Conclusions
Health-related factors predict re-incarceration after adjustment for demographic and criminal justice factors. Further research is required to establish the reproducibility of our findings and understand the causal pathways linking health at release from prison to re-incarceration.

Complementary and Integrative Approaches for ADHD

June 19, 2015 Comments off

Complementary and Integrative Approaches for ADHD
Source: National Center for Complementary and Integrative Health

Surveys estimate that as many as 9 percent of American children and 4 percent of adults have attention-deficit/hyperactivity disorder (ADHD). Although stimulant medications have been shown to be helpful for at least 70 percent of children with ADHD, many adults and children use complementary health approaches such as omega-3 fatty acids, melatonin, herbs and other dietary supplements, special diets, neurofeedback, and several mind and body practices, including acupuncture and meditation to control ADHD symptoms. Many of these complementary health approaches have been studied for ADHD, but none has been conclusively shown to be more effective than conventional therapies.

This issue of the digest provides information on what the science says about some of these complementary approaches for ADHD.

See also: 7 Things To Know About Complementary Health Approaches for ADHD

American Association of Psychiatry in Law — Practice Guideline for the Forensic Assessment

June 16, 2015 Comments off

Practice Guideline for the Forensic Assessment
Source: Journal of the American Academy of Psychiatry and the Law

This document is intended as a review of legal and psychiatric factors to offer practical guidance in the performance of forensic evaluations. It is a guideline developed through the participation of forensic psychiatrists who routinely conduct a variety of forensic assessments and who have expertise in conducting these evaluations in a variety of practice settings. The developmental process incorporated a thorough review that integrated feedback and revisions into the final draft. The final version was reviewed and approved by the Council of the American Academy of Psychiatry and the Law on October 26, 2014. Thus, the Guideline reflects a consensus among members and experts about the principles and practices applicable to the conduct of forensic assessments. However, it should not be construed as dictating the standard for forensic evaluations. While it is intended to inform practice, it does not present all currently acceptable ways of performing forensic evaluations, and following its recommendations does not lead to a guaranteed outcome. Differing facts, clinical factors, relevant statutes, administrative and case law, and the psychiatrist’s judgment determine how to proceed in any individual forensic assessment.

The Guideline is for psychiatrists and other clinicians working in a forensic role who conduct evaluations and provide opinions in legal and regulatory matters. Any clinician who agrees to perform forensic assessments in any domain is expected to have the qualifications necessary to meet the professional standards in the relevant jurisdiction and to complete the evaluation at hand.

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