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This study evaluates the capacity of a school-based family referral service to support school personnel in connecting at-risk students with appropriate community agencies. Through a partnership between New South Wales government departments and a not-for-profit counselling organisation, the family referral service was piloted at four regional, government schools. In phase 1 of the mixed methods evaluation, 135 students completed an online version of the Student Engagement Instrument. In phase 2, 32 primary and secondary teachers participated in four focus groups. Four principals and 19 key stakeholders participated in individual, semi-structured interviews. Findings showed the service increased the schools' capacity to manage students who were at risk of underachievement and poorer educational outcomes and reduced the workload of principals and teachers. While high Student Engagement Instrument subscale scores were obtained for extrinsic motivation and relationships with teachers, family support for learning received the lowest scores. Recommendations for the wider promotion of school-family partnerships focussing on locating flexible, family referral services within schools are discussed.

Cigarette smoking is common among pregnant women with substance use disorders (SUD) and may contribute to more adverse health consequences for the infant than alcohol and illicit drug use. However, most studies focused on stopping illicit drug use and paid little attention to cigarette smoking in pregnant women with SUD. To identify predictors of current smoking among pregnant women with SUD, given past-month psychological distress, alcohol use and illicit drug use, the receipt of past-year mental health and substance use treatment controlling for potential confounders. Secondary analysis of cross-sectional data from the National Survey on Drug Use and Health (NSDUH) 2015–2019 was conducted. The NSDUH included 3,540 pregnant women aged 18–44 years; among them were 195 lifetime smokers with SUD. Multiple logistic regression modeling was used to examine the probability of prenatal smoking. Sixty-one percent of pregnant women with SUD reported current cigarette smoking. The likelihood of prenatal smoking increased with a higher level of past-month psychological distress (Adjusted Odds Ratio [AOR] 1.14; 95% Confidence Interval [CI]: 1.02–1.28), past-month illicit drug use (AOR: 5.68; 95% CI: 1.59–20.21), and past-year substance use treatment receipt (AOR: 5.73; 95% CI: 1.88–17.45). The receipt of substance use treatment markedly increased the probability of smoking in pregnant women with SUD. Treatment and policy initiatives are required to address and integrate cigarette smoking within other substance use treatment modalities for pregnant women with SUD. [ABSTRACT FROM AUTHOR]

Objective: Quick access to substance use treatment is associated with better outcomes, but little is known about COVID-19's impact on access and retention. This study examined the relationship between COVID-19-related practice changes and quick access fidelity outcomes of the Sobriety Treatment and Recovery Teams (START) program, which serves families with co-occurring substance use and child abuse/neglect. Method: This study was a retrospective cohort comparison. On March 23, 2020, most START child welfare and treatment services were shifted to a virtual format because of the COVID-19 pandemic. Families referred to the program between that date and March 23, 2021, were compared with families served the year before (i.e., March 23, 2019, to March 22, 2020). Cohorts were compared across nine fidelity outcomes (e.g., number of days to complete four treatment sessions), with differences assessed using chi-square tests and independent samples t tests. Results: Referrals to START were 14% lower during the first COVID-19 year than in the prior year, with a greater percentage of referred cases being accepted during COVID-19. Transition to virtual service provision was not related to quick access fidelity outcomes; however, adults referred in the year before COVID-19 were more likely to complete four treatment sessions than adults referred during the first COVID-19 year. Conclusions: In this study, quick access to services and initial engagement did not appear to be negatively affected by virtual service provision resulting from COVID-19. However, during COVID-19, fewer adults completed four treatment sessions. In a largely virtual treatment environment, additional engagement and pre-treatment services may be necessary. [ABSTRACT FROM AUTHOR]

Our objective was to determine if past-year mental illness and substance use disorders (SUD) among pregnant smokers predicted the probability of receipt of counselling for cigarette smoking cessation. A secondary analysis of data from the National Survey on Drug Use and Health 2016–2019 was conducted. We found that approximately 83% of pregnant smokers (N = 373) received screening for cigarette smoking, and 65% received cessation counselling. Having mental illness predicted the probability of receipt of counselling for smoking cessation in pregnant smokers (adjusted odds ratio [ AOR ]: 3.75; 95% confidence interval [CI]: 1.25–11.27). However, having SUD (alcohol [ AOR : 2.30; 95%CI: 0.57–9.26] or illicit drug use [ AOR : 1.32; 95%CI: 0.26–6.82]) or comorbid mental illness and SUD (AOR : 0.23; 95%CI: 0.03–2.03) was not associated with receipt of counselling for smoking cessation. Practice guidelines and policy initiatives are needed to reduce cigarette use and its related adverse health outcomes in pregnant smokers with SUD. [ABSTRACT FROM AUTHOR]

Little is known about factors associated with child welfare case duration. Understanding factors associated with case duration may help stakeholders make more informed decisions about funding and service allocation and improve compliance with federal law. This study had two research questions: (1) What factors are associated with child welfare case duration? And (2) Do factors differ depending on whether children were placed exclusively with parents or with others (e.g. relatives and foster care) during the case? The study sample consisted of families (N = 874) with co‐occurring child maltreatment and substance use in one midwestern state in the United States between 2007 and 2016. Linear regression models were used to identify correlates of case duration while controlling for child placement status. Overall, having a child under 1 year of age, benzodiazepine use, methamphetamine use and injection drug use were all associated with longer case duration, whereas marijuana use with no other substance use was associated with shorter case duration. Additionally, factors associated with case duration differed based on child placement status during the case. These findings suggest important heterogeneity in families involved with child welfare services and may allow for proactive mitigation of cases at greater risk. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to describe the prevalence and correlates of nonmedical prescription drug misuse (PDM) in a state population of youths in residential care for antisocial behavior. Method: Interviews assessing substance use, psychiatric symptoms, antisocial traits/behavior, and traumatic life experiences were conducted with 723 Missouri youths. Participants were predominantly male (87.0%), averaged 15.5 (SD = 1.2) years of age, and constituted 97.7% of the service population sampled. Results: Overall, 314 youths (43.4%) reported lifetime PDM; 33.7%, 32.0%, and 11.2% had misused prescription opioids, tranquilizers, and barbiturates, respectively. Prescription drug misusers were significantly older, and larger proportions were girls, were White, and resided in small towns, compared with non-prescription drug misusers. Prescription drug misusers evidenced significantly more varied, frequent, and problematic psychoactive drug use; evidenced higher levels of distressing psychiatric symptoms; and were nearly twice as likely to have been diagnosed with a psychiatric disorder, compared with non-prescription drug misusers. Traumatic life events, experiences of criminal victimization, and suicidal ideation were significantly more prevalent in the histories of prescription drug misusers, compared with non-prescription drug misusers. In multiple logistic regression models, older age; White racial status; prior inhalant, marijuana, and LSD (lysergic acid diethylamide) use; residence in a small town; and impulsivity were associated with increased risk for PDM. Conclusions: Adolescents in residential care for antisocial behavior have high rates of PDM, as well as comorbid psychiatric and behavioral problems. Youths served in institutional settings should be routinely screened and treated for PDM and co-occurring disorders. (J. Stud. Alcohol Drugs, 71, 917-924, 2010), MOST EPIDEMIOLOGICAL RESEARCH examining adolescent prescription drug misuse (PDM) has been conducted in schools or, to a lesser degree, in homes. School-based studies, such as the Monitoring the Future (MTF; [...]

Objectives: To (1) compare the probability of cigarette smoking cessation for pregnant women with and without past‐year mental illness by the trimester of pregnancy; and (2) examine the association between the receipt of past‐year mental health treatment and prenatal cigarette smoking cessation among pregnant lifetime‐smokers with mental illness. Methods: We conducted secondary analysis of data from the National Survey on Drug Use and Health (NSDUH) 2008–2014. The NSDUH included 2019 pregnant lifetime smokers aged 18–44 years, 528 of whom had a mental illness. We used multiple logistic regression to model the probability of prenatal cigarette smoking cessation. Results: Pregnant lifetime‐smokers with mental illness had a lower rate of cigarette smoking cessation than women without mental illness (47.9% vs. 61.7%, p = 0.001). Compared to pregnant women without mental illness, pregnant women with mental illness had a significantly lower odds of smoking cessation in the first trimester (Adjusted Odds Ratio [AOR]: 0.34, 95% Confidence Interval [CI]: 0.18–0.66), but not in the second (AOR: 0.87, 95% CI: 0.46–1.63) and third trimesters (AOR: 0.94, 95% CI: 0.51–1.72). The likelihood of quitting smoking did not differ significantly for pregnant lifetime‐smokers with mental illness who received and did not receive mental health treatment (AOR: 1.69, 95% CI: 0.87–3.28). Conclusion: Pregnant lifetime‐smokers with mental illness are less likely to quit smoking than those without mental illness; overall, pregnant women tended to quit smoking as they progressed in their pregnancy. The receipt of mental health treatment was not associated with quitting smoking. Mental health care providers need to screen for cigarette use among pregnant women and strengthen smoking cessation efforts. Clinical relevance: Pregnancy presents a unique opportunity for mental health care providers to screen for cigarette use in women with mental illness and support their smoking cessation efforts. [ABSTRACT FROM AUTHOR]

Purpose: To compare trends in mental health and substance use disorders and treatment receipt of pregnant and nonpregnant women from 2008 to 2014.Methods: Using data from the 2008-2014 National Survey on Drug Use and Health, logistic regression was used to compare trends in mental health and substance use disorders and treatment receipt for mental health and substance use disorders among propensity score-matched groups of pregnant (n = 5520) and nonpregnant women (n = 11,040). Among women in the matched sample who met criteria for at least one mental illness, trends in mental health treatment receipt of pregnant (n = 1003) and nonpregnant women (n = 2634) were compared.Results: There were no differences in the trends by pregnancy status from 2008 to 2014. Past-year anxiety disorder, past-month psychological distress and illicit drug use disorder increased in the total sample from 2008 to 2014, yet trends in mental health treatment and unmet need for substance use treatment did not change over time. Pregnant women had lower odds of mental illness, but those who had mental illness were less likely to receive mental health treatment than their nonpregnant counterparts.Conclusions: There is a need for preventive strategies addressing anxiety disorder, psychological distress and illicit drug use among women of childbearing age as well as initiatives to increase access to mental health treatment among pregnant women. [ABSTRACT FROM AUTHOR]

Families in the child welfare (CW) system who cannot be engaged in services are at high risk of negative outcomes. As motivational interviewing (MI) has been shown to improve engagement in similar contexts. This study aimed to systematically review MI with CW families as well as MI training with CW workers and social work students training to become CW workers. The review used Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and searched multiple databases in June 2018. In September 2019, the initial search was repeated with additional searches to identify gray literature. Eight studies described the acquisition of MI among CW workers or student trainees, and 11 studies evaluated the impact of MI on families in CW. MI's impact on some family outcomes, such as engagement in services, was mixed, though MI paired with other evidence-based treatments showed positive effects. With regard to training CW workers and students in MI, differences in training duration, intensity, and modality make conclusions difficult, though trainees generally described MI favorably and some studies showed training increased worker empathy and self-efficacy. Importantly, few published studies have evaluated whether MI-trained CW workers impact out-of-home-care placement, and no studies have evaluated their impact on maltreatment. [ABSTRACT FROM AUTHOR]