Doctor of Healthcare Administration (D.H.A.), Franklin University, 2023, Health Programs

The Crisis Intervention Team (CIT) program is a partnership of law enforcement agencies, the behavioral healthcare system, emergency departments (EDs), advocacy groups, and other stakeholders in a geographic region. People in the community who experience a crisis related to a behavioral health (BH) condition often encounter police officers, and the CIT program offers guidance on the safe handling of those situations that ideally ends with a connection to treatment. In the United States, crisis BH resources are often unavailable, and it is common for officers to resolve the situation by initiating an ED visit, which is not associated with positive health outcomes for the patient. The aim of this study is to test the implications of Structural Functional Theory (SFT) in one CIT program. SFT suggests that imbalanced systems lead to the inappropriate reliance on other systems. The analysis of crisis events may provide insight into potential BH system improvements that align with the goals of the CIT program. One research question aims to find predictors of each disposition option available to LE officers in the CIT program. Findings in this study are drawn from the quantitative analysis of 594 CIT encounters over a 3-year period. The results of the multinomial logistic regression models indicate that adolescents and young adults experience suicide-related crises more often than other types of crises, and the most likely outcome is an ED visit. Findings suggest that the local system could benefit from improvements in BH resources, especially in crisis situations.

Committee: Gail Frankle (Committee Chair); Jesse Florang (Committee Member); Dail Fields (Committee Member) Subjects: Health Care Management

Doctor of Philosophy, The Ohio State University, 2024, Educational Studies

Each year in the United States, an estimated 57.8 million adults and 7.7 million children experience mental health issues with far-reaching implications (National Alliance on Mental Illness [NAMI], 2023). Despite our increased awareness in the aftermath of the COVID-19 pandemic, which both exposed and exacerbated the problem, access to services remains severely limited for 163 million Americans living in Mental Health Professional Shortage Areas (NAMI, 2023). There is an insufficient supply of mental health providers in America, and an additional 8,251 practitioners are needed immediately to adequately meet the needs of the people (Health Resource & Services Administration [HRSA], 2023b). However, this deficit will not be resolved soon, as nearly half of mental health practitioners currently report intentions to leave their employment (Centers for Disease Control [CDC], 2023). Furthermore, resolving the shortage will require more than hiring additional mental health professionals (HRSA, 2023b). Compared to the larger workforce, mental health providers have a higher risk of experiencing detrimental occupational outcomes (Cocker & Joss, 2016; Ledoux, 2015; Ondrejkova & Halamova, 2022; Sinclair et al., 2017; Sorenson et al., 2016). Burnout, one of the occupational harms associated with the unique demands of care work, is a driving force in the provider retention problem (CDC, 2023; Hoge et al., 2007; Morse et al., 2012). Although there is a direct link between burnout and a lack of organizational support (Schaufeli & Greenglass, 2001), there is a lack of research examining systemic causal factors. Most existing studies neglect to explore links between work characteristics and employee well-being and are restricted to investigating individual traits as contributors (CDC, 2023). The present study confronts the gap in the literature through a systemic exploratory analysis. This quantitative study examined the link between workplace environments and mental health (open full item for complete abstract)

Committee: Darcy Haag Granello (Committee Chair); Paul Granello (Committee Member); Noelle Arnold (Committee Member) Subjects: Behavioral Sciences; Behaviorial Sciences; Clinical Psychology; Counseling Education; Counseling Psychology; Health Care; Health Care Management; Medical Ethics; Mental Health; Occupational Health; Occupational Psychology; Organization Theory; Organizational Behavior; Psychology; Psychotherapy; Public Health; Public Health Education; Systems Design; Therapy

MS, Kent State University, 2018, College of Arts and Sciences / Department of Computer Science

Posting on the internet, including weblogs or social media, is one of the ways individuals seek for an outlet to express themselves or mental health concerns. For many mental health issues such as psychosis, the timing of detection and treatment is critical; short and long-term outcomes are better when individuals begin treatment close to the onset of psychosis. While the internet offers a positive medium for short term therapy, it is not a face to face therapy session, wherein a trained professional is better able to deduce the root of the problem. Many clinicians are adopting electronic communication to strengthen their therapeutic alliance with their patients. The drawback of psychiatry is that it lacks objectified tests for mental illnesses that would otherwise be present in medicine. Current neuroscience has yet not found genetic markers that can characterize individual mental illnesses. A thought disorder (ThD) which is a widely found symptom in people suffering from schizophrenia, is diagnosed from the level of coherence when the flow of ideas is muddled without word associations. A system that can explore the use of speech analysis for aiding in psychiatric diagnosis is highly desirable and would help early detection and effective treatment results. This thesis introduces a framework – Prediction Onset Prediction System (POPS) - to predict the onset of psychosis based on written language habits. A scrape of a multitude of individual comments is analyzed using a trained psychosis prediction module that is able to predict if an individual is psychotic (based on the semantics) using natural language processing, machine learning techniques and a customized corpus with terms consist with psychotic language tendencies created using speech analysis techniques. The effectiveness of the corpus and its implication in psychosis detection is explored.

Committee: Kambiz Ghazinour (Advisor) Subjects: Computer Science; Health; Mental Health; Psychology; Sociology; Teaching; Technology

Doctor of Philosophy (PhD), Ohio University, 2011, Educational Administration (Education)

This study contributes to the research regarding processes and procedures utilized by two institutions of higher education to respond to students who participate in inappropriate behavior and who are concomitantly experiencing a mental health crisis. A case study analysis of two institutions of higher education was used to examine this issue. The institutions studied were located within the Midwest and Southern regions of the United States. Qualitative methodologies including document review, observation and interviews were conducted on each campus studied. Interviews with four professional staff members were conducted from each campus and transcribed. The data obtained was first separated by institution and then using a cross case analysis approach, similarities and dissimilarities were identified and discussed. Multiple common themes were discovered during this study. There is a need for institutions to have available a comprehensive set of processes and procedures that can withstand a legal challenge as well as provide multiple options for addressing student misbehavior. The positive impact of a multidisciplinary crisis response team that is well trained, trusting and collaborative was also realized. Furthermore, the necessity for administrators to be keenly aware of legal renderings such as student privacy issues and under what circumstances it is appropriate to release information to others was also identified in this study. Finally, the need to commit the time and resources necessary to developing a systemic approach to resolving incidents where students misbehave and are also concomitantly experiencing a mental health crisis was verified. Recommendations for practice and areas for future research are also included.

Committee: Peter Mather PhD (Committee Chair); John Hitchcock PhD (Committee Member); Yegan Pillay PhD (Committee Member); Jim Sand PhD (Committee Member); Robert Young PhD (Committee Member) Subjects: Higher Education Administration

Doctor of Philosophy (Ph.D.), Bowling Green State University, 2024, Media and Communication

The World Bank classifies the Lebanese economic crisis as one of the 10 worst such crises globally since the 19th century—and possibly one of the top three. Azma fawq ‘azma [crisis upon crisis] includes financial collapse, inability to care for 1.5 million refugees, the highest number of refugees per capita in the world, the devastation of the COVID-19 pandemic on an already fragile healthcare system, and the catastrophic explosion in Beirut, one of the worst non-nuclear explosions in human history, that killed 218 people, injured 7,000, and left 300,000 unhoused. Due to unprecedented levels of inflation, the Lebanese pound has lost 90% of its value, food prices have risen 500%, and 80% of the population lives in poverty. These crises have transformed Lebanon from a beacon of success to a failed state. Given the severe lack of organizational communication research in the Mashreq (Middle East), this dissertation is of particular importance as it fills a critical gap in research. The dissertation takes an interdisciplinary approach to examine how NGOs mobilize support, provide services, and engage in interorganizational collaboration to support citizens, residents, and asylum seekers struggling to survive in Lebanon. The triangulated methodological approach includes policy analysis, two phases of field research in Lebanon, and in-depth interviews with leaders, administrators, employees, and volunteers representing 52 NGOs. Interview respondents (n = 64) provided first-hand experiences, insights, and assessments of NGOs' efforts to combat intersecting crises, reflected on the complexity of these crises, and highlighted the need for economic and political reform to assuage the feelings of being trapped in the azma fawq ‘azma. Emergent themes include the importance of collective identity through interorganizational collaboration, the benefits of group cohesion in providing support and services, a sense of purpose that has expanded alongside the crises, a continuing (open full item for complete abstract)

Committee: Lara Martin Lengel Ph.D. (Committee Chair); Lori Brusman Lovins Ph.D. (Committee Member); Terry Rentner Ph.D. (Committee Member); Ellen Gorsevski Ph.D. (Committee Member) Subjects: Area Planning and Development; Banking; Communication; Economics; Management; Middle Eastern Studies; Minority and Ethnic Groups; Near Eastern Studies; Organization Theory; Organizational Behavior; Peace Studies; Political Science; Regional Studies; Rhetoric; Sustainability

Master of Music (MM), Ohio University, 2024, Music Therapy (Fine Arts)

This thesis begins the conversation regarding ethical treatment of patients undergoing an acute mental crisis. A survey instrument was used to gain perspectives of board certified music therapists regarding acute patient care. Most music therapists stated they have treated patients undergoing an acute mental crisis. This survey found commonalities in music therapist educational experiences and differences in how music therapists perceive the future needs of music therapy.

Committee: Jessica Fletcher (Advisor) Subjects: Health; Health Care; Medicine; Mental Health; Music

Doctor of Education (Educational Leadership), Youngstown State University, 2022, Department of Teacher Education and Leadership Studies

Increased school shootings and various issues with school safety across the country have brought the need for schools to discuss how they will protect their pupils and staff. As school safety measures increase to include active shooter drills, high-tech equipment, school resource officers (SROs), armed teachers, and social workers, the entire school community is tasked to find the most productive and cost-efficient solution. The pros and cons of investing in various proactive measures are weighed out in the local media, at the state department of education level, and on a national level too. The current mixed-methods investigation focuses on the perspectives of 18 total SROs, administrators, teachers, and recent graduates on school safety and arming teachers. The participants were located in rural, suburban, and urban school districts. Data was collected via QMethod Software. Results indicate that most participants' perspectives were identified in one of two factors. Qualitative follow-up questions demonstrated emerging themes regarding school safety concerns, the arming of teachers, the impact on learning for students housed in classrooms with armed teachers, how to ensure safety for everyone, physical safety measures within schools, and mental health resources situated in schools. Results from the current investigation can inform school officials and school communities on viewpoints of who should carry weapons at school, the impact of carrying a weapon on a child's education, and if school personnel need further information on the physical safety measures and mental health resources located within their districts.

Committee: Karen Larwin Ph.D. (Advisor); Patrick Spearman Ph.D. (Committee Member); Sherri Harper Woods D.M. (Committee Member); Kenneth Miller Ph.D. (Committee Member) Subjects: Education; Education Policy; Public Policy; Teacher Education

MA, University of Cincinnati, 2021, Arts and Sciences: Communication

This research study aims to analyze legislation regarding marginalized communities, with news media communication and government official communication thereof. In order for a public health issue to be considered a crisis, it must 1) affect a large number of people, 2) threaten the health of a group over the long-term, and 3) require adoption of large-scale solutions to combat the issue (Galea, 2017). Racism is, and always has been, a public health crisis. Racism has had debilitating consequences on marginalized communities for centuries; socially, politically, economically, etc. After the “Racism as a Public Health Crisis” legislation was introduced by Representative Jahana Hayes in 2020, numerous cities, counties, and states in the United States began declaring racism a public health crisis. Consequently, these declarations require action-steps by elected officials and community members to dismantle structural racism interwoven within policies and practices. Using Iyengar's (1993) Thematic Framing, this study proposes 3 prominent frames of the “racism as a Public Health Crisis” legislation: Public Health, Social Justice, and Political frames. Furthermore, Tajfel's (1979) Social Identity Theory expands upon the use of the pronouns “we” and “them” to categorize members of in-groups and out-groups. With the analysis of twenty news media and government artifacts, this study highlights the most prominent frames by coding words, terms, race of those quoted, as well as the use of an individual or collective narrative identity.

Committee: Ronald Jackson II Ph.D. (Committee Chair); Omotayo Banjo Ph.D. (Committee Member); Nancy Jennings Ph.D. (Committee Member) Subjects: Communication

Doctor of Philosophy, University of Toledo, 2019, Counselor Education

Law enforcement officers experience significant effects on their physical and mental health because of their employment. These effects frequently go untreated due to the stigma related to having mental health needs and attending treatment. Often, law enforcement culture perpetuates stigma. Addressing stigma and culture are barriers to treatment engagement frequently left unaddressed. Without understanding this link, even the most effective treatment will be left unattended. Thus,making prioritizing treatment engagement essential for addressing law enforcement officer's mental health. The current study aimed to increase understanding of how the Crisis Intervention Team training impacted law enforcement officer's help-seeking behaviors. This training is designed to decrease the stigma of law enforcement officers in working with individuals with mental illness in the community. An Exploratory Single Case Study, Embedded design (SCSED) was utilized to gain an understanding of how participation in one community CIT training affected law enforcement officers' help-seeking behaviors.The study included 11 participants including LEO training participants, LEO training facilitators, and mental health provider training facilitators. Findings indicated that the CIT program did not influence participant LEO help-seeking behavior. However it did increase their comfort and knowledge in reaching out to their peers regarding their peer's mental health.

Committee: John Laux (Committee Chair); Madeline Clark (Committee Member); Christopher Roseman (Committee Member); Kasey Tucker-Gail (Committee Member) Subjects: Counseling Education

Doctor of Philosophy, The Ohio State University, 1976, Graduate School

Committee: Not Provided (Other) Subjects: Sociology

Doctor of Philosophy (PhD), Ohio University, 2016, Counselor Education (Education)

Research shows that stress in the workplace can contribute to negative physical and mental health outcomes among workers in a variety of settings, while the personality disposition of Hardiness can serve as a protective factor against those outcomes. Existing literature on human services professionals shows that Perceived Work Stress and Hardiness can predict Professional Quality of Life, which includes the positive outcome of Compassion Satisfaction and the negative outcomes of Burnout and Secondary Traumatic Stress (Stamm, 2010). The purpose of the current study was to determine whether Perceived Work Stress and the Hardiness components of Control, Commitment, and Challenge predict Compassion Satisfaction, Burnout, and Secondary Traumatic Stress among Emergency Services and Assessment (ES) clinicians in the Commonwealth of Virginia. ES clinicians conduct prescreening assessments for involuntary psychiatric hospitalizations and are exposed to unique work stressors. A secondary aim of the current study was to determine if there are interactions among the variables that better explain the relationships. Findings indicated that Perceived Work Stress and Hardiness are significant predictors of Professional Quality of Life for ES clinicians, but not all components of Hardiness made significant contributions to each regression model. The Hardiness component of Commitment did not significantly predict Secondary Traumatic Stress. The Hardiness component of Challenge did not significantly predict any of the outcome variables. Perceived Work Stress, Control, and Commitment accounted for 58.3% of the variance in Compassion Satisfaction. Perceived Work Stress, Control, and Commitment accounted for 65.2% of the variance in Burnout. Perceived Work Stress and Control accounted for 31.2% of the variance in Secondary Traumatic Stress. No interaction effects were detected among the predictor variables that better explained the relationships in the regression models for (open full item for complete abstract)

Committee: Christine Bhat (Committee Chair); Yegan Pillay (Committee Member); Tom Davis (Committee Member); Dianne Gut (Committee Member) Subjects: Counseling Education; Counseling Psychology; Occupational Psychology

PhD, University of Cincinnati, 2003, Nursing : Doctoral Program in Nursing

The purpose of this quasi-experimental study was to examine the effect of a nonviolent crisis intervention program on the perceived self-efficacy of community mental health center staff. The research was guided by Social Cognitive Theory, using the construct of self-efficacy, which is belief in one's capabilities (Bandura, 1986). Crisis intervention self-efficacy, along with seven other variables believed to influence crisis intervention self-efficacy were investigated: anxiety arousal, avoidant behavior, interpersonal self-efficacy, participant behavior, perceived risk, personal vulnerability, and risk discernment. The sample was non-randomized and consisted of 90 multidisciplinary mental health staff conveniently selected from two community mental health centers. The experimental group (n. = 56) received The Nonviolent Crisis Intervention® training program targeted toward managing potentially violent clients; the control group (n = 34) received no training. Data were collected using self-administered questionnaires immediately prior to the training, at the conclusion of the training, and six months later. The ANOVA showed there was a significant main effect for group (F [1,80] = 0.16, p < 0 .01, h =.15) and for time (F [1,80] = 10.17, p < .01. h=.11). Subjects who participated in the training demonstrated greater self-efficacy when compared to the subjects who did not have the training, and subjects who participated in the training increased their self-efficacy mean scores over time. Path analysis revealed a causal structure with interpersonal self-efficacy, risk discernment, and anxiety impacting personal vulnerability that mediated perceived risk, ultimately influencing crisis intervention self-efficacy. The results suggest community mental health staff that received the non-violent crisis training professed greater confidence in their ability to manage potentially violent clients. Perceived risk and interpersonal self-efficacy appear to directly influence crisi (open full item for complete abstract)

Committee: Dr. Evelyn Fitzwater (Advisor) Subjects: