Harm Reduction in Community Mental Health Settings

Mancini, Michael A.; Linhorst, Donald M.

doi:10.1080/1536710x.2010.493481

Cited by 15 publications

(8 citation statements)

References 61 publications

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“…Extensive morbidity is also associated with non-fatal overdoses, including physical injury, falling, or personal assaults [ 24 ]. Overdose prevention and harm reduction programs, such as peer-based education and naloxone training, as well as expanding treatment options, can be expected to help decrease youth hospitalization [ 25 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

Hospitalization among street-involved youth who use illicit drugs in Vancouver, Canada: a longitudinal analysis

et al. 2018

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BackgroundStreet-involved youth who use illicit drugs are at high risk for health-related harms; however, the profile of youth at greatest risk of hospitalization has not been well described. We sought to characterize hospitalization among street-involved youth who use illicit drugs and identify the most frequent medical reasons for hospitalization among this population.MethodsFrom January 2005 to May 2016, data were collected from the At-Risk Youth Study (ARYS), a prospective cohort study of street-involved youth in Vancouver, Canada. Multivariable generalized estimating equation (GEE) was used to identify factors associated with hospitalization.ResultsAmong 1216 participants, 373 (30.7%) individuals reported hospitalization in the previous 6 months at some point during the study period. The top three reported medical reasons for hospital admission were the following: mental illness (37.77%), physical trauma (12.77%), and drug-related issues (12.59%). Factors significantly associated with hospitalization were the following: past diagnosis of a mental illness (adjusted odds ratio [AOR] = 1.85; 95% confidence interval [95% CI] 1.47–2.33), frequent cocaine use (AOR = 2.15; 95% CI 1.37–3.37), non-fatal overdose (AOR = 1.76; 95% CI 1.37–2.25), and homelessness (AOR = 1.40; 95% CI 1.16–1.68) (all p < 0.05).ConclusionsFindings suggest that mental illness is a key driver of hospitalization among our sample. Comprehensive approaches to mental health and substance use in addition to stable housing offer promising opportunities to decrease hospitalization among this vulnerable population.

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Section: Discussionmentioning

confidence: 99%

Hospitalization among street-involved youth who use illicit drugs in Vancouver, Canada: a longitudinal analysis

et al. 2018

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“…Further, out-of-treatment IDUs who inject MA, particularly frequently, would likely benefit from improved suicide risk assessment and other mental health support services within health care and community-based settings. Although the incorporation of harm reduction principles within community-based mental health programs is a relatively new phenomenon (Mancini and Linhorst, 2010), improved integration between harm reduction interventions and mental health programs including suicide prevention efforts for this population may be fruitful.…”

Section: Discussionmentioning

confidence: 99%

Injection methamphetamine use is associated with an increased risk of attempted suicide: A prospective cohort study

Marshall

Galea

Wood

et al. 2011

Drug and Alcohol Dependence

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Background Methamphetamine (MA) use is a growing public health concern in many settings around the world. While some physical and mental health effects associated with injection MA use have been well described, little is known about the relationship between injecting MA and suicidal behavior. We sought to determine whether MA injection was associated with an increased risk of attempting suicide among a prospective cohort of injection drug users (IDUs) in Vancouver, Canada. Methods Between 2001 and 2008, eligible participants enrolled in the Vancouver Injection Drug Users Study (VIDUS) completed semi-annual questionnaires that elicited information regarding sociodemographics, drug use patterns, and mental health problems including suicidal behavior. We used Cox proportional hazards models with time-dependent covariates to determine whether self-reported MA injection was an independent predictor of attempting suicide at subsequent time points. Results Of 1873 eligible participants, 149 (8.0%) reported a suicide attempt, resulting in an incidence density of 2.51 per 100 person-years. Participants who attempted suicide were more likely to be younger (median: 35 vs. 40, p<0.01), female (48.3% vs. 35.1%, p<0.01), and of Aboriginal ancestry (43.6% vs. 31.3%, p<0.01). In a Cox proportional hazards model, MA injection was associated with an 80% increase in the risk of attempting suicide (adjusted hazard ratio = 1.80, 95%CI: 1.08 – 2.99, p=0.02). Conclusions These findings suggest that IDUs who inject MA should be monitored for suicidal behavior. Improved integration of mental health and suicide prevention interventions within harm reduction and drug treatment programs may be fruitful.

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“…It may also involve learning new skills to manage cravings and avoid risky situations, learn assertiveness and problem solving skills in order to manage situations that can jeopardize their recovery, or learn new skills around employment, eating, sleeping, daily living, and relationships. It is important for behavior health agencies to integrate billing, records, assessment and treatment practices, and professional development activities that promote the routine and effective use of stage-based interventions when helping clients with behavioral health issues into their policies and procedures (Mancini and Linhorst 2010;Mancini and Miner 2013;Mancini and Wyrick-Waugh 2013).…”

Section: Transtheoretical Model Of Changementioning

confidence: 99%