Current and Preferred Housing of Psychiatric Consumers/Survivors

As part of a participatory action research project, we surveyed 300 psychiatric consumers/survivors from southwestern Ontario regarding their housing preferences and housing satisfaction. We found that, while 79% of the sample preferred independent living, 76% were living in some other type of setting (e.g., temporary shelter, supportive housing, sheltered care). Those living in temporary shelters reported the lowest levels of housing satisfaction, and those who were living in the type of housing that they preferred had the highest levels of housing satisfaction. This information is being used by stakeholder groups involved in the project to help build the capacity of the community to provide the types of housing that are preferred by consumers/survivors

The Article Idea Chart: A participatory action research tool to aid involvement in dissemination

Participatory-action research encourages the involvement of all key stakeholders in the research process and is especially well suited to mental health research. Previous literature outlines the importance of engaging stakeholders in the development of research questions and methodologies, but little has been written about ensuring the involvement of all stakeholders (especially non-academic members) in dissemination opportunities such as publication development. The Article Idea Chart was developed as a specific methodology for engaging all stakeholders in data analysis and publication development. It has been successfully utilised in a number of studies and is an effective tool for ensuring the dissemination process of participatory-action research results is both inclusive and transparent to all team members, regardless of stakeholder group.Keywords: participatory-action research, mental health, dissemination, community capacity building, publications, authorshi

Perceptions of stigma among people with lived experience of methamphetamine use within the hospital setting: qualitative point-in-time interviews and thematic analyses of experiences

ObjectivesAs part of a larger mixed-methods study into harm reduction in the hospital setting and people with lived experience of methamphetamine use, stigma was found to be a prominent issue. The aim of this secondary analysis was to investigate the issue of stigma.DesignParticipants completed a one-time qualitative interview component to assess their experiences in the hospital setting.SettingThe study setting included secondary and tertiary care in Southwestern Ontario, Canada. Participants who had received care from these settings were also recruited from an overdose prevention site, a primary healthcare center, a national mental health organization, an affordable housing agency, and six homeless-serving agencies between October 2020 and April 2021.ParticipantsA total of 104 individuals completed the qualitative component of a mixed-methods interview. Sixty-seven participants identified as male, thirty-six identified as female, and one identified as non-binary. Inclusion criteria included past or current use of methamphetamine, having received services from a hospital, and being able to communicate in English.MethodsOpen-ended questions regarding experiences in the hospital setting were asked in relation to the lived experience of methamphetamine. A secondary analysis was conducted post-hoc using a thematic ethnographic approach due to prominent perceptions of stigma.ResultsThree themes were identified. The first theme identified that substance use was perceived as a moral and personal choice; the second theme pertained to social stigmas such as income, housing and substance use, and consequences such as being shunned or feeling less worthy than the general patient population; and the third theme highlighted health consequences such as inadequate treatment or pain management.ConclusionThis study revealed that stigma can have consequences that extend beyond the therapeutic relationship and into the healthcare of the individual. Additional training and education for healthcare providers represents a key intervention to ensure care is non-stigmatizing and patient-centered, as well as changing hospital culture

Mothers with Serious Mental Illness: Their Experience of “Hitting Bottom”

This study sought to understand the experience of “hitting bottom” from the perspective of 32 mothers with serious mental illness. Secondary narrative analysis of 173 stories about experiences related to hitting bottom were identified. Enactment of their perceived mothering roles and responsibilities was compromised when confronted by the worst of illness. Subsequent to women's descent to bottom was their need for a timely and safe exit from bottom. An intense experience in bottom further jeopardized their parenting and treatment self-determination and, for some, their potential for survival. The results suggest that prevention of bottom is feasible with early assessment of the diverse issues contributing to mothers' vulnerabilities. Interventions to lessen their pain may circumvent bottom experiences. Healing necessitates purposeful approaches to minimize the private and public trauma of bottom experiences, nurture growth towards a future, and establish resources to actualize such a life

Extrinsic Factors Influencing the Person’s Motivation for Engagement and Retention in the Addiction Recovery Process. A Systematic Literature Review

Background Globally, up to 80% of patients enrolled for addiction care are lost to follow-up within the first three months of treatment. This review synthesizes evidence on extrinsic factors that influence motivation for engaging in addiction recovery and corresponding empirical definitions. Methods A systematic search for peer-reviewed articles was conducted through electronic databases, including Ovid MEDLINE, PsychINFO, CINHAL, and scanning references. The included articles were published in English or French between 1946 and 2018. Results The identified sixteen articles indicated that extrinsic factors for the person’s engagement and retention in the addiction recovery process included: motivation-enhancing healthcare structures, therapeutic relationships, and supportive social networks. Results also indicated that empirical definitions of motivation for engagement and retention in the addiction recovery process varied across studies. Conclusion Extrinsic factors can influence the person’s motivation for engagement and retention in the addiction recovery. Research with full operational definitions of motivation for engagement and retention in the addiction recovery is needed. Keywords: Addiction recovery; engagement; extrinsic factors; motivation; retentio

Health seeking behaviors among Syrian refugee women: A scoping review

Objective: The aim of this scoping review was to explore what is known about the health seeking behaviors among Syrian refugee women within hospital and community settings. The objectives were to explore health seeking behaviors of Syrian refugee women and highlight specific issues that are important to Syrian refugee women related to seeking for health care. In addition, to uncover potential obstacles/barriers that face Syrian refugee women while seeking for health care. Methods: Arksey and O’Malley (2005) framework for scoping review was utilized to guide the review process and to explore health seeking behaviors of Syrian refugee women. Various databases such as, Academic Search Complete, CINAHL, PubMed, Scopus, PsycINFO, Science direct and SocINDEX were utilized in the review. The search strategy consisted of broad queries, in the title, abstract, full texts and keyword fields. The search included studies published from 2011 on, that is, from the time the Syrian conflict started (March 2011) and were limited to those in the English language. Thematic analysis was undertaken to synthesize extracted data. Results: A total of 19 studies were selected for this review. The data from this review were organized along two thematic categories (accessibility of health care services) and (awareness of health care needs and available health care services). Accessibility of health care services was the most frequently reported theme throughout this area of the literature and is most often include (financial barriers, language barriers, availability of culturally and gender appropriate health services). Awareness of health care needs and available health care services was the second commonly encountered theme within the area of Syrian refugee’s women health seeking behaviors. Conclusions: Having available and accessible health care services for Syrian refugee women in host countries is a fundamental human right that can enhance Syrian refugee women health, wellbeing and quality of life. An awareness of the potential health seeking behaviors, obstacles/barriers and challenges that facing Syrian refugee women may help to promote their accessibility to health services and consequently improve their health and wellbeing. Practitioners can use this review findings to inform future policy, education and developments in practice. Further research is required to develop and evaluate initiatives that target the identified barriers and help Syrian refugee women to fulfil their unmet health care needs

An Iterative Association Rule Mining Framework to K-Anonymize a Dataset

Preserving and maintaining client privacy and anonymity is of utmost importance in any domain and specially so in healthcare, as loss of either of these can result in legal and ethical implications. Further, it is sometimes important to extract meaningful and useful information from existing data for research or management purposes. In this case it is necessary for the organization who manages the dataset to be certain that no attributes can identify individuals or group of individuals. This paper proposes an extendable and generalized framework to anonymize a dataset using an iterative association rule mining approach. The proposed framework also makes use of optional domain rules and filter rules to help customize the filtering process. The outcome of the proposed framework is a preprocessed dataset which can be used in further research with confidence that anonymity of individuals is conserved. Evaluation of this research will also be described in the form of a case study using a test dataset provided by the Lawson Health Research Institute in London, Ontario, Canada as a part of their Mental Health Engagement Network (MHEN) study

Case 6 : No Fixed Address: A Cost-Effectiveness Analysis of a Program to Prevent Psychiatric Discharge to Homelessness

Najwa D\u27Souza, the CEO of Hampden Health Care, is looking for an intervention that will reduce the rate of discharge to homelessness from the psychiatric units at her hospitals. She is presented with the No Fixed Address (NFA) program as a possible solution. This intervention is a multipronged, hospital-based intervention that provides support to psychiatric clients who are either experiencing homelessness or are at risk of homelessness. To implement the program at Hampden Health Care, hospital staff would refer clients they suspect are at risk of being discharged to homelessness to the NFA program. From there, clients would have the option of receiving streamlined Ontario Works support or seeing a housing advocate who is employed by the local shelter system, Hampden Community House. Excited about the possibilities this intervention holds, Najwa must conduct an economic evaluation to assess the NFA program’s value for money, and support decision making for Hampden Health Care and other relevant stakeholders. Students take the perspective of someone on Najwa’s health economics team. They are given a list of parameters including the types, quantities, and costs per unit of the resources needed for the two interventions being compared (usual care versus NFA program). Students must incorporate the parameters into a model-based economic evaluation comparing the costs and consequences of the alternative interventions. Students are then tasked with working through the rest of the steps to complete a cost-effectiveness analysis

Discharge of Psychiatric Patients to Shelters Increases Homelessness

A comprehensive care plan for patients, including at least income support and assistance resettling in the community, will prevent homelessness.York's Knowledge Mobilization Unit provides services and funding for faculty, graduate students, and community organizations seeking to maximize the impact of academic research and expertise on public policy, social programming, and professional practice. It is supported by SSHRC and CIHR grants, and by the Office of the Vice-President Research & Innovation. [email protected] www.researchimpact.c

Community-Based Discharge Planning Improves Health Services

Basing discharge services in the community has improved services for people transitioning out of an acute care mental healthcare facility. It has also reduced readmissions rates, curbing the demand for inpatient services at the hospital level.York's Knowledge Mobilization Unit provides services and funding for faculty, graduate students, and community organizations seeking to maximize the impact of academic research and expertise on public policy, social programming, and professional practice. It is supported by SSHRC and CIHR grants, and by the Office of the Vice-President Research & Innovation. [email protected] www.researchimpact.c