Peer specialists helped people with serious mental illness feel more comfortable and motivated during coaching sessions encouraging behavior change to counter obesity, according to research from the Brown School at Washington University in St. Louis.
Researchers conducted qualitative interviews with residents of supportive housing for people with serious mental illnesses such as schizophrenia or bipolar disorder. Researchers also interviewed peer specialists, who use their own experiences living with mental illness to deliver services that promote wellness and recovery for those facing similar challenges.
They found that the shared experiences made those receiving services from peers more comfortable, supported and motivated.
“Peer specialists’ disclosure of their own experiences making health behaviors changes was critical for building participants’ motivation and ability to try lifestyle changes,” wrote Leopoldo J. Cabassa, senior study author and associate professor at the Brown School. “Understanding these mechanisms can help inform core competencies, training and practice standards to better prepare the workforce to deliver health interventions that could improve health behaviors.”
The study was published December 18 in Administration and Policy in Mental Health and Mental Health Services Research. Read more here.
Public-health professionals in Europe reported that a course in evidence-based public health helped them acquire knowledge that was useful in their work and strengthened their leadership role in promoting better decision-making, according to new research from the Brown School at Washington University in St. Louis.
Since 2002, the Prevention Resource Center at the Brown School has taught the annual course, “Evidence-Based Public Health (EBPH): A Course in Noncommunicable Disease Prevention,” in collaboration with international organizations and funded by the Centers for Disease Control and Prevention. The purpose of the course has been to strengthen the capacity of public health professionals to apply and adapt evidence-based programs in disease prevention.
Researchers surveyed 188 public health professionals who participated in the course during the period from 2007-2016, and conducted in-depth, qualitative interviews with 20 of them.
Results showed that participants understood the importance of using reliable sources and sound data; they also noted the value of being able to accurately evaluate programs. Barriers to EBPH included a lack of funding and time, as well as training deficits in co-workers. Similar results have been found in surveys of U.S. participants in the class, but the European study was the first to assess the impact of the course over a decade.
“Targeting those in leadership roles may help facilitate the growth of evidence-based decision-making across different countries,” wrote the study’s lead author, Natalicio Serranno, a doctoral student at the Prevention Research Center.
The paper was published April 3 in Global Health Promotion.
Robert Motley Jr., a doctoral candidate at the Brown School and manager of the Center for Social Development’s Race and Opportunity Lab, has received a two-year $60,936 grant from the National Institute on Minority Health and Health Disparities and a $5,000 grant from the Fahs-Beck Fund for Research and Experimentation.
The funding is for his dissertation study entitled “Racism-Based Trauma, Emerging Adults, and Substance Abuse.”
The funding “signals the significance of the work,” Motley said. “Findings from the research will increase our knowledge of the prevalence and disparities in exposure to police use of force and also identify risk factors that substance-use prevention and intervention programs can target to assist black emerging adults.”
Motley’s research focuses on advancing methodology for measuring exposure to racism-based police use-of-force events and understanding of the relationship between exposure to police use of force, trauma symptoms and substance use for black people who are 18-29 years old.
In the United States, almost 50,000 people die every year from suicide. While participating in a June 12 briefing on Capitol Hill in Washington, D.C., a Washington University in St. Louis expert testified that — amid the need nationally to stem violence in schools and elsewhere — suicide remains preventable.
And prevention methods go beyond behavioral means, testified Sean Joe, the Benjamin E. Youngdahl Professor of Social Development at the Brown School.
“Gun suicides are higher in states with the least restrictions with access to lethal means,” he told the panel. “What we’re talking about, if you’re in the Mountain states, part of the Southern states and in the Midwest states, your rates of suicide are higher than in states … with limited access to lethal means. Lethal means [are key]. When you engage in suicidal behavior, if you use a firearm, you are 95% more likely to die” compared to non-firearm attempts at suicide.
The congressional briefing, “The Impact of Weapons and Violence on School and Surrounding Communities,” aimed to address current scientific data surrounding the pressing need to reduce violence in schools and communities. The American Educational Research Association, the American Academy of Social and Work and Social Welfare, the National Academy of Education, and the Clark-Fox Policy Institute sponsored the briefing.
Joe is a national expert and leading authority on suicide among Black Americans, specifically Black adolescent males.
“On average, every 11 minutes someone kills themselves in the United States,” Joe told the panel. “I remember when we averaged around 30,000 suicides 20 years ago. In addition to those almost 50,000 [suicides] every year … every year … we see over 1.5 million attempted suicides. Sixty percent of violent incidents involving a firearm are suicides.”
“To put this into its right context, what often happens when you focus on interpersonal violence is that you stimulate the public fear, and public fear is often the model that often legislation usually is driven by. Rather than the fear that we’re losing loved ones: families, fathers, uncles, daughters and children under the age of 12.”
Suicide accounts for one of every five deaths of young people in the United States and is the third-leading cause of death among those 15 to 24, he said. Too often, people such as teachers, professionals, colleagues and others surrounding young people default to “dehumanizing” tendencies.
“It’s up to those adults to be able to recognize the humanity in our young people, and it’s often ignored,” Joe said. “The implicit bias comes because people don’t see the young people that they’re working with as even being worthy of their time, although it’s their job.”
Joe made four recommendations for addressing the problem:
- Eliminate the ban or any restriction on the ability of the Centers for Disease Control and Prevention to conduct research on and monitor suicide violence in this country, in particular firearm-related violence.
- Fully fund a national violent-death reporting system. This would provide comprehensive information about how people die by violent injury, “not just guns.”
- Suicide prevention training for mental health professionals. “Most professionals get no training around suicide,” he said.
- Create safe storage capacity for guns or other lethal means in the communities of people while they are in crisis.
“These are common-sense things we can do,” Joe said.
Early exposure to emotional violence “significantly” increases the chances that youths will contemplate suicide, according to new research from three countries conducted by Washington University in St. Louis’ Brown School.
“We find the odds of suicide ideation are consistently and significantly greater for adolescents who report overexposure to emotional violence,” said Lindsay Stark, associate professor and co-author of the study “A Sex-disaggregated Analysis of How Emotional Violence Relates to Suicide Ideation in Low- and Middle-income Countries,” published in the journal Child Abuse & Neglect.
The same consistency is not observed for any other form of maltreatment across countries, found Stark and co-author Ilana Seff of Columbia University.
Stark and Seff reviewed national data drawn from 9,300 adolescents and young adults aged 13-24 in the Violence Against Children Surveys, a collaborative effort by the U.S. Centers for Disease Control and Prevention, UNICEF, country governments and other bilateral and multilateral organizations.
They collected surveys from Haiti, Kenya and Tanzania containing detailed information on young people’s experiences with physical, emotional and sexual violence, as well as their mental health and well-being.
Questions about emotional violence included whether adults had ever threatened to abandon the children, made them feel unwanted, or humiliated them in front of others. Stark and Seff found an association between youth with those experiences and the ones who considered suicide.
Approximately 26%–45% of respondents, depending on sex and country, reported having ever experienced emotional violence. Self-reported suicide ideation was consistently higher for females in all countries; nearly 27%, 15% and 8% of females had ever considered suicide in Haiti, Kenya and Tanzania, respectively, compared to 8%, 7% and 6% of males.
“We find there exists a significant relationship between exposure to emotional violence and suicide ideation for both males and females in all countries in the sample,” the authors wrote in the paper. “No other form of child maltreatment was found to be associated with suicide ideation in more than one country, suggesting that emotional violence may actually be more powerful than physical and sexual abuse in its impact on adolescent suicide behaviors in low- and middle-income countries.”
The analysis suggests that mental health practitioners should offer suicide prevention programs to those with a history of emotional abuse.
With the goal of preventing youth suicide by helping schools set up a student support system, the Brown School at Washington University in St. Louis hosted the Hope Policy Academy June 6.
“Schools represent a significant opportunity to identify, link and provide mental health services for youth who are not connected to mental health resources and create an opportunity to significantly shift the trajectory of suicide in our country, if given the adequate resources,” said Ryan Lindsay, assistant dean for social work and an associate professor of practice, who was one of the featured speakers at the conference in Hillman Hall.
“Approximately 80% of youth who die by suicide were not connected to year prior to their death, and only 7.5% received mental health services in the month prior to their death,” he said. “Therefore, schools are likely interfacing with these youth. By improving our suicide response systems, we have an opportunity to identify youth sooner and link to early interventions. This requires improving school capacity to develop, implement and evaluate suicide prevention policies and practices. The Hope Policy Academy is attempting to fill this gap.”
Most Missouri school districts aren’t prepared to prevent, intervene or properly support students contemplating suicide and/or the school community after the death of a student, said Lindsay, who teaches and advises students in the mental health concentration in the Master of Social Work program.
“At best, there may be intervention policies, but what about support post-attempt?” Lindsay asked. “How does one communicate to a student body after the death of a peer? The ways in which this happens matters greatly, and even more so because the Missouri Department of Elementary and Secondary Education has mandated that each district should have a prevention, intervention and ‘postvention’ policy and practice in place.”
(Postvention refers to a school’s response to healing after the loss of a student by suicide.)
Lindsay has a forthcoming study, conducted between March and November 2018, that has found that among 72 Missouri school districts surveyed, 63.49% had a suicide intervention policy; 54.95% had a suicide prevention policy; and 43% had a suicide postvention policy — in spite of Missouri House Bill 1593 requiring suicide prevention policies to be in place by July 1, 2018.
Additionally, the study found that most of the Missouri districts with suicide prevention/intervention/postvention policies serve predominantly white students.
“Our study showed significant variability in schools’ current capacity to implement suicide prevention and intervention policies, specifically among schools that serve lower income and predominantly non-white students,” he said. “These results have implications related to racial equity in school capacity to address suicide in schools and suggest that community stakeholders prioritize this equity gap.”
The Hope Policy Academy was organized by Lindsay and the Brown School as a response to that identified gap. It was aimed at school-based stakeholders who are charged with developing, implementing and evaluating school-based suicide prevention policies in Missouri.
In collaboration with Erika Gonzalez, manager of urban education initiatives at the Brown School, and Saras Chung, executive director of SkipNV, a St. Louis provider of education space and opportunities, the event’s vision of bringing together over 100 school stakeholders from across the state was realized.
“The conference provided an opportunity for Missouri school stakeholders to receive technical assistance to help facilitate the development and implementation of model suicide prevention policies,” Lindsay said. “The Hope Policy Academy provided information on best practices to improve existing suicide prevention policies and practices.”