Mary Ann Priester

Treatment Access Barriers and Disparities Among Individuals with Co-Occurring Mental Health and Substance Use Disorders: An Integrative Literature Review

The purpose of this integrative review is to examine and synthesize extant literature pertaining to barriers to substance abuse and mental health treatment for persons with co-occurring substance use and mental health disorders (COD). Electronic searches were conducted using ten scholarly databases. Thirty-six articles met inclusion criteria and were examined for this review. Narrative review of these articles resulted in the identification of two primary barriers to treatment access for individuals with COD: personal characteristics barriers and structural barriers. Clinical implications and directions for future research are discussed. In particular, additional studies on marginalized sub-populations are needed, specifically those that examine barriers to treatment access among older, non-White, non-heterosexual populations.

Barriers and Facilitators to Substance Use Treatment in the Rural South: A Qualitative Study

PURPOSE Little qualitative research has examined factors associated with care in substance abuse treatment agencies in Southeastern rural communities. This study explored client- and agency stakeholder-perceived barriers and facilitators to substance use treatment delivery in southeastern rural communities. METHODS Group and individual interviews were conducted with 40 key stakeholders and 40 clients at 9 substance abuse agencies serving rural communities in a southeastern state. Qualitative thematic analysis was used to identify perceived barriers and facilitators to substance abuse services in rural communities. FINDINGS Four primary themes emerged from the client and stakeholder interviews as both barriers and facilitators: availability of services for individuals with substance use disorders; access to the current technology for client services and agency functioning; cost of services; and stigma. CONCLUSIONS This study identifies novel barriers and facilitators to substance use care in the rural South and highlights essential areas for consideration when developing and implementing substance use care in this geographic region. These findings can be used as guidelines to provide better care to individuals with substance use disorders living in rural communities.

Who Is The Help? Use of Film to Explore Diversity

Helping learners understand the intersectionality of gender, race, and class can be challenging. This study describes the use of the film The Help to stimulate discussion about racism and intersectionality. As evidenced by posttest survey data, the film enabled learners to identify the importance of gender, race/ethnicity, and social class. Qualitative analysis revealed that viewing The Help with a diverse audience can provide a forum to explore multiple concepts associated with intersectionality. This study shows that carefully selected films help remove some barriers to learning cultural competence by creating an environment in which individuals feel safe discussing personal biases.

Are Discrimination and Social Capital Related to Housing Instability

Abstract Existing studies examining social capital and housing instability have overlooked structural factors such as discrimination, providing an incomplete explanation of the relationship between social capital and housing instability. This study addresses this limitation by exploring how discrimination and social capital are related to housing instability. This study is a secondary analysis of data collected during the Atlanta Neighborhood Pilot study. The sample consists of mostly African American adults who resided in the Atlanta metropolitan area in 2013 (n = 691). After controlling for sociodemographic characteristics, residential mobility, and public assistance, stepwise logistic regression identified social capital and discrimination as significant predictors of housing instability. Lower social capital and higher everyday discrimination scores were associated with increased odds for housing instability. Individuals 35 or older, those with annual incomes between

Teaching Strategies for Addressing Poverty Awareness With Aspiring Helping Professionals

25,000 and

Increasing Awareness of Diversity Through Community Engagement and Films

50,000, and those who reported receiving public assistance during their lifetime also had increased odds for housing instability. Findings identify characteristics of individuals vulnerable to housing instability and suggest that social capital development as a housing intervention warrants further exploration. These findings can be utilized by policymakers and practitioners to better target funding and to create efficient systems better equipped to deploy early homelessness prevention interventions.

Improving the Efficacy of Administrative Data for Evaluation of Holistic Defense

This study describes the use of guided learning activities that exposed aspiring helping professionals to the challenges and discrimination experienced by individuals living in poverty. Pretest/posttest and qualitative analysis of participants’ reactions to a Poverty Simulation and a Bridges Out of Poverty Workshop were analyzed to explore perceived learning benefits reported by 43 master of social work (MSW) students. Incorporating poverty content into masters-level social work curriculum stimulated classroom discussions about how the lived experiences of individuals living in poverty impact the service relationship between helping professionals and clients. This observational study evaluated the effectiveness of the used strategies and methods in impacting individual assumptions about socioeconomic class and illustrated the value of university–community collaborations in supporting diversity education and awareness both on and off campus.

Examining the Relationship Between Diversity Exposure and Students’ Color-Blind Racial Attitudes and Awareness of Racial Oppression

This observational study explored the use of films to create a forum to engage various audiences, including the general public, social work students, and socioeconomically disadvantaged youths. Three film events were held at a large public university. Participant feedback via online forums and panel discussions was analyzed to evaluate the efficacy of using film to facilitate learning about cross-cultural experiences. Vicarious experience through film was found to be useful for multicultural education with varied audiences. Findings indicate that films make a difficult topic safer by objectifying it and removing some of the barriers to learning cultural competence. Further opportunities for university–community partnerships should be developed to enhance multicultural education, to inspire students, and to engage the community.

A Review of Family Engagement Measures for Adolescent Substance Use Services

ABSTRACT A college of social work developed a partnership with a state commission on indigent defense to examine existing data-collection procedures, potential case outcomes, and practical implications of implementing holistic defense programs. The holistic defense model responds to the complex challenges of justice-system-involved defendants by providing social services in public defense offices. Using chi-square and logistic regression analyses of administrative data for a sample of 15,994 public defendants from a single judicial circuit, this research study examined case outcomes before and after implementation of a holistic defense program. Results were mixed regarding effectiveness of holistic defense in mitigating the effect of justice involvement for indigent defendants. Implementation of holistic defense was associated with a decrease in case dismissals. However, defendants receiving holistic representation were less likely to be indicted than defendants prior to program implementation. Once indicted, there were no changes in levels of diversions, and more defendants were held on bond, convicted as guilty, and incarcerated. After program implementation, fewer defendants were sentenced to alternatives to incarceration; more defendants were sentenced to time served, avoiding further incarcerative penalty. These findings suggested the need for further research to determine whether holistic defense practices are producing desired legal and social service outcomes.

A Dedicated Diversity Course or an Infusion Model? Exploring Which Strategy Is More Effective in Social Work Pedagogy

ABSTRACT This cross-sectional study surveyed graduate-level social work and undergraduate psychology students (N = 409) at a large university to explore the association of diversity exposure (diversity of undergraduate institution, diversity of childhood neighborhood, previous diversity courses), and color-blind racial attitudes and awareness of racial oppression. White students scored significantly higher on level of color-blind racial attitudes compared to racial/ethnic minorities. Students who attended predominantly White undergraduate institutions had greater awareness of racial oppression than students who attended racially balanced or institutions comprised exclusively of one racial/ethnic group other than White. Understanding how diversity exposure influences color-blind racial attitudes and awareness of racial oppression will better inform multicultural training and curricular delivery.