Mental Health and Other Risk Factors for Jail Incarceration Among Male Veterans

Data derived from the 2002 Survey of Inmates in Local Jails and the 2000 National Survey of Veterans show that having mental health problems in addition to such sociodemographic characteristics as being a member of a minority group, not being married, having less education, and being younger are risk factors for incarceration among veterans, as they are for the general population. As in previous studies veterans who served during the Vietnam Era and to an even greater extent, those who served in the early years of the All Volunteer Force were at greater risk of incarceration than veterans from the most recent period of the AVF, after controlling for age and other factors.

The Healthy Immigrant Effect on Mental Health: Determinants and Implications for Mental Health Policy in Spain

Since the mid-1990s, Spain has started to receive a great number of migrant populations. The migration process can have a significantly negative impact on mental health of immigrant population and, consequently, generate implications for the delivery of mental health services. The aim of this article is to provide empirical evidence to demonstrate that the mental health of immigrants in Spain deteriorates the longer they are resident in the country. An empirical approach to this relationship is carried out with data from the National Survey of Health of Spain 2011–2012 and poisson and negative binomial models. Results show that immigrants who reside <10 years in Spain appear to be in a better state of mental health than that observed for the national population. Studying health disparities in the foreign population and its evolution are relevant to ensure the population’s access to health services and care. The need for further research is especially true in the case of the immigrant population’s mental health in Spain because there is scant evidence available on their situation.     

Socioeconomic Disparities and Metabolic Risk in Veterans with Serious Mental Illness

Socioeconomic disparities were assessed in predicting metabolic risk among veterans with serious mental illness. Veterans with schizophrenia, schizoaffective, or bipolar disorders were identified in VISN 4 facilities from 10/1/2010 to 9/30/2012. Differences between patients with and without metabolic syndrome were compared using t-tests, Chi square tests and multivariate logistic regressions. Among 10,132 veterans with mental illness, 48.8% had metabolic syndrome. Multivariate logistic regression analysis confirmed that patients with metabolic syndrome were significantly more likely to be older, male, African-American, married, and receiving disability pensions but less likely to be homeless. They were more likely to receive antipsychotics, antidepressants, or anticonvulsants. Bivariate cross-sectional analysis revealed that patients with metabolic syndrome had higher rates of coronary artery disease, cerebrovascular disease, and mortality, and that metabolic syndrome was more often associated with emergency visits and psychiatric or medical hospitalizations. Demographics, socioeconomic status and medications are independent predictors of metabolic syndrome and should be considered in broader screening of risk factors in order to provide preventive interventions for metabolic syndrome.     

Consumer Satisfaction with Inpatient Mental Health Treatment in the Department of Veterans Affairs

This study used hierarchical linear models to analyze post-discharge data among 17,130 veterans who received inpatient VA mental health services between 1995 and 2001, in order to determine whether changes in mental health service affected inpatient satisfaction. In models without covariants, half the satisfaction measures increased while the other half indicated no significant change. After adjusting for changes in patient characteristics, however, nine measures indicated no change and seven showed significant declines. Demonstrating the importance of risk-adjustment, satisfaction appeared to increase over time prior to risk adjustment, but declined after adjusting for changes in patient characteristics that were associated with patient satisfaction.     

Mental disorders and mental health treatment among U.S. Department of Veterans Affairs outpatients: the Veterans Health Study

OBJECTIVE: The authors examined the self-reported presence and treatment of current depressive disorder, posttraumatic stress disorder (PTSD), and alcohol-related disorder in a group of outpatient veterans. METHOD: Data were obtained from the Veterans Health Study, a longitudinal investigation of male veterans' health. A representative sample of 2,160 outpatients (mean age = 62 years) was drawn from Boston-area U.S. Department of Veterans Affairs (VA) outpatient facilities. The participants completed screening measures for depression, PTSD, and alcohol-related disorder. Mental health treatment was assessed by interviews. RESULTS: The screening criteria for at least one current mental disorder were satisfied by 40% (N = 856) of the patients. Screening rates were 31% (N = 676) for depression, 20% (N = 426) for PTSD, and 12% (N = 264) for alcohol-related disorder. Patients who screened positively for current mental disorders were younger, less likely to be married or employed, and more likely to report traumatic exposure than were those without mental disorders. Of those who met the screening criteria for any of the targeted mental disorders, 68% (N = 579) reported receiving mental health treatment. Younger, Caucasian men and those who reported more traumatic exposure were more likely to report receiving mental health treatment than were others who screened positively for mental disorders. CONCLUSIONS: Screening rates of depression and PTSD and rates of mental health treatment were considerably higher among these VA outpatients than among similar patients in primary care in the private sector. Although the VA is currently meeting the mental health care needs of its patients, future fiscal constraints could affect most adversely the treatment of non-Caucasian and older patients and those with a history of traumatic exposure.     

The Association between Physical Education and Mental Health Indicators in Adolescents: A Cross-Sectional Study

Objective: To explore the associations between physical education attendance and mental health indicators.Methods: Using data from the Global Student Health Survey, the frequency of physical education attendance,suicidality-related indicators, loneliness, bullying, and anxiety were all assessed using a standardized self-reportedquestionnaire. Multivariable logistic regression was used to estimate the association between physical educationattendance and mental health-related indicators. Results: The study included 276,169 participants from 71 countries (47.3% males, aged 11–18 years old). After controlling for sex, age, food insecurity, close friends, physicalactivity, sedentary time, others’ help, and parents’ understanding, physical education attendance was not signifi-cantly associated with suicidal attempts, suicidal ideation, and anxiety. However, compared with no physical education attendance, individuals attending physical education for 1, 2, as well as 5 or more days had significantlyreduced odds/ratios of suicide; only 2 days of physical education attendance was associated with a lower oddsratio for suffering from loneliness. Even 1 day of physical education was associated with not being bullied byothers. Conclusion: This study suggests that physical education attendance may not have an effective role inreducing mental health illnesses in children and adolescents. Future studies are encouraged to corroborate ornegate our research discoveries by using better and further improved study designs.     

Perceived Purpose in Life,Mental Health,and Suicidality in Older U.S. Military Veterans: Results From the National Health and Resilience in Veterans Study

ObjectiveTo determine the current prevalence of perceived purpose in life (PIL) and its association with screening positive for mental disorders and suicidality in a nationally representative sample of predominantly older U.S. veterans.MethodsData were analyzed from the 2019–2020 National Health and Resilience in Veterans Study (N = 4,069; M_age = 62.2). Veterans were classified into three groups based on perceived PIL level (i.e., low, average, and high). Self-report assessments were administered to screen for mental disorders and suicidality.ResultsMost veterans endorsed average PIL (71.7%), while 16.0% endorsed low PIL and 12.4% endorsed high PIL. A “dose-response” association was observed between PIL and outcomes. High PIL was associated with 42%–94% reduced odds of screening positive for major depressive, generalized anxiety, posttraumatic stress, and substance use disorders, as well as suicide attempts, ideation, and future intent.ConclusionHigher PIL is associated with lower odds of mental disorders and suicidality in U.S. veterans, underscoring the potential importance of interventions to bolster PIL in this population.     

Distance Matters in Choice of Mental Health Program: Policy Implications for Reducing Racial Disparities in Public Mental Health Care

The purpose of this study is to examine the influence of race, geographic distance and quality on the choice of community mental health programs. The study population was comprised of adult Medicaid recipients who received outpatient treatment for serious mental illness in FY 2001. A discrete choice model was employed to examine the likelihood of choosing one program over another. Quality was measured based on follow-up after hospital discharge and continuity of care in outpatient services. Maps showing the relationship between race and the quality of care were prepared to visually confirm the results of the statistical analysis. African American and Hispanic clients were less likely to travel further for treatment, while no significant difference was found between the Caucasian and other race groups. Caucasian subjects were more likely to choose programs with a higher quality of care compared to Hispanic or African American clients. Higher income clients were, on average, traveling longer and receiving better quality of care after controlling for race. The results suggested that clients living in higher income White neighborhoods are more likely to travel longer distances for mental health treatment. Special attention must be paid to improve the quality of care in lower income minority neighborhoods to insure equity of treatment in publicly funded programs.     

Factor Structure and Risk Factors for the Health Status of Homeless Veterans

Homeless veterans have numerous health problems that have been previously characterized as falling into four major subgroups; addiction, psychosis, vascular disorders, and generalized medical and psychiatric illness. Comorbid conditions are common, often involving a combination of psychiatric and medical disorders. Using data from the same survey of homeless veterans that was used to establish these subgroups with cluster analysis, the present study examined the structure of these subgroup patterns through the use of factor analysis. This analysis yielded a five factor solution. They were named “Cardiac”, Mood, Stress, Addiction, and Psychosis factors. Factor scores were computed and an odds ratio analysis was accomplished to determine the association between obtaining a high score on a given factor with a number of sociodemographic and homelessness related variables. It was concluded that health status of homeless veterans is a complex condition, but has a clear latent structure demonstrated by factor analysis. Scoring high or low on a particular factor is associated with numerous historical and sociodemographic considerations, notably age, ethnicity, and employment status.     

Mental Health Care Use in Children of Parents with Mental Health Problems: Results of the BELLA Study

Whether parental mental health problems facilitate or hinder the use of mental health care of the parents´ children is still unclear. The present cross sectional study examined mental health care use and potential predictors in a population based sample. Children of parents with mental health problems (CPM) were nearly 5 times more likely to use mental health care compared to children of parents without mental health problems. A multiple regression analysis revealed that the most important predictors of mental health care use for CPM were active family life (OR?=?2.67) and children´s own mental health problems (OR?=?1.18 self-report, 1.17 parent-report). Additionally, parental strain showed a tendency to predict mental health care use (OR?=?2.45). This study demonstrates that parental mental health problems are associated with mental health care use in their children and that improving certain family factors may support children´s mental health care use.     

Adaptation of Intensive Mental Health Intensive Case Management to Rural Communities in the Veterans Health Administration

There has been increasing concern in recent years about the availability of mental health services for people with serious mental illness in rural areas. To meet these needs the Department of Veterans Affairs (VA) implemented the Rural Access Networks for Growth Enhancement (RANGE) program, in 2007, modeled on the Assertive Community Treatment (ACT) model. This study uses VA administrative data from the RANGE program (N = 343) to compare client characteristics at program entry, patterns of service delivery, and outcomes with those of Veterans who received services from the general VA ACT-like program (Mental Health Intensive Case Management (MHICM) (N = 3,077). Veterans in the rural program entered treatment with similar symptom severity, less likelihood of being diagnosed with schizophrenia and having had long-term hospitalization, but significantly higher suicidality index scores and greater likelihood of being dually diagnosed compared with those in the general program. RANGE Veterans live further away from their treatment teams but did not differ significantly in measures of face-to-face treatment intensity. Similar proportions of RANGE and MHICM Veterans were reported to have received rehabilitation services, crisis intervention and substance abuse treatment. The rural programs had higher scores on overall satisfaction with VA mental health care than general programs, slightly poorer outcomes on quality of life and on the suicidality index but no significant difference on other outcomes. These data demonstrate the clinical need, practical feasibility and potential effectiveness of providing intensive case management through small specialized case management teams in rural areas.     

Developing Quality Indicators for Family Support Services in Community Team-Based Mental Health Care

Quality indicators for programs integrating parent-delivered family support services for children’s mental health have not been systematically developed. Increasing emphasis on accountability under the Affordable Care Act highlights the importance of quality-benchmarking efforts. Using a modified Delphi approach, quality indicators were developed for both program level and family support specialist level practices. These indicators were pilot tested with 21 community-based mental health programs. Psychometric properties of these indicators are reported; variations in program and family support specialist performance suggest the utility of these indicators as tools to guide policies and practices in organizations that integrate parent-delivered family support service components.     

The Mental Health of Federal Offenders: A Summative Review of the Prevalence Literature

To date, only a small number of government and peer-reviewed studies have examined the mental health of federal offenders. Although these studies provide isolated bits of information they have yet to be organized into a coherent body of knowledge from which clinicians, administrators and policy makers can inform their work. As a first step in constructing this knowledge and understanding the possible mental health needs of this population (currently America's largest correctional population), this paper delineates the available government and peer-reviewed studies on federal offenders, highlights their convergent findings, and suggests opportunities for growth in research, administration and policy.     

Multimorbidity among Veterans Diagnosed with PTSD in the Veterans Health Administration Nationally

Psychiatric Quarterly - Over 30% of veterans treated for psychiatric disorders in the Veterans Health Administration (VHA) are diagnosed with Post-Traumatic Stress Disorder (PTSD), with most...