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Sex and gender are regarded as critical structural determinants of mental health and mental illness. Mental illness is a complex phenomenon, and risky behaviour and substance use commonly occur simultaneously or subsequent to one another. A gendered vulnerability in biological, environmental, and behavioural risk factors has been registered in the development and escalation of mental illness. Studies have found that women who use drugs experience greater physical and mental health repercussions than men. Women who use drugs present higher rates of depression and anxiety, suicidal tendencies, isolation and general psychological distress. This chapter addresses the most common mental illnesses associated with women who use drugs: depression, anxiety, trauma-related disorders, and eating disorders.

It is unclear whether information obtained from a one parent can be used to infer the other parent's history of psychopathology. Two hundred and one parental dyads were asked to complete psychiatric interviews. Based on maternal report, non-participating husbands/ fathers had higher rates than participating fathers of psychiatric illness. For fathers who did participate, maternal report did not match direct interview of paternal psychopathology with sensitivities less than 0.40 and positive predictive values of 0.33 to 0.74. Psychopa -thology may be over-represented among fathers who do not participate in research. Mother report of paternal symptoms is not an effective proxy. Alternative methods need to be developed to: i) improve father participation or ii) identify psychiatric status in fathers who do not participate in research projects.

While there is a growing amount of literature showing that lesbian, gay, bisexual, transgender and queer (LGBTQ people) are more at risk to use substances compared to non-LGBTQ people, there is a gap in knowledge about the exploration of the life narrative, before and the turning point of substance use. The purpose of this paper is to discuss life narrative, before and the turning point of substance use.

Ten participants from diverse sexual orientation/gender were invited to join this study including queer, lesbian, transgender, gay, tomboy and bisexuals who were diagnosed with a substance use disorder. The narrative qualitative research was used as the research methodology. Each of the participants had in-depth interviews with the research team once or twice, with each time lasting from 30 to 120 min until the saturation of the data. Thematic analysis and the trustworthiness process were used to analyze the data.

Three themes emerged from this study including the following: life before substance use; life turning point; and motivation to stop using substances. Each theme had several categories to define the theme.

The results of this study can help counseling psychologists and clinicians who work with LGBTQ addicts to become aware that there is not only psychological treatment available for LGBTQ addicts needed for recovery, but also a social movement that promotes equality among LGBTQ people, such as advocacy against oppression with regard to family, school, community and the public.

Childhood-onset schizophrenia (COS) refers to schizophrenia with onset of psychotic symptoms prior to a child's 13th birthday. Optimal treatment likely includes family-based services supplementing antipsychotic pharmacotherapy. However, family-based services can require adjustment based on parental psychopathology; there has been little literature exploring the frequency or type of psychopathology seen in parents of COS cases. This report includes the results of a structured psychiatric evaluation on 80 parents of a COS case with comparison to a sample of 304 parents. Having a child with psychosis and being of minority racial/ethnicity status increased risk for psychiatric illness. Psychotic disorders (15% vs. 5%), mood disorders (54% vs. 27%), anxiety disorders (30% vs. 18%), and substance use disorders (49% vs. 31%) were all increased in the parents with a psychotic child. Psychiatric illness is common in parents of a child with COS and will need to be considered as family-based services for COS are developed.

Roughly half a million persons in the USA are homeless on any given night and over a third of those individuals have significant alcohol/other drug (AOD) problems. Many are chronically homeless and in need of assistance for a variety of problems. However, the literature on housing services for this population has paid limited attention to comparative analyses contrasting different approaches. The paper aims to discuss these issues.

The authors examined the literature on housing models for homeless persons with AOD problems and critically analyzed how service settings and operations aligned with service goals.

The authors found two predominant housing models that reflect different service goals: sober living houses (SLHs) and housing first (HF). SLHs are communally based living arrangements that draw on the principles of Alcoholics Anonymous. They emphasize a living environment that promotes abstinence and peer support for recovery. HF is based on the premise that many homeless persons with substance abuse problems will reject abstinence as a goal. Therefore, the HF focus is providing subsidized or free housing and optional professional services for substance abuse, psychiatric disorders, and other problems.

If homeless service providers are to develop comprehensive systems for homeless persons with AOD problems, they need to consider important contrasts in housing models, including definitions of “recovery,” roles of peer support, facility management, roles for professional service, and the architectural designs that support the mission of each type of housing.

This paper is the first to consider distinct consumer choices within homeless service systems and provide recommendations to improve each based upon architecture and community planning principles.

Repetitive transcranial magnetic stimulation (rTMS) is a neurostimulatory technique used to modulate orbital frontal corticostriatal (OFC) activity and clinical symptomatology for psychiatric disorders involving OFC dysfunction. We examined the effectiveness of rTMS in the treatment of major depressive disorder in an applied clinical setting (Awakening KC CNI) to assess efficacy and optimize rTMS parameters within clinical practice. A retrospective review of medical records was carried out on patients with major depressive disorder undergoing rTMS therapy at Awakenings KC Clinical Neuroscience Institute (CNI), a suburban tertiary psychiatric clinic. A detailed de-identified data set of clinical outcomes was compiled. Patient Health Questionnaire 9 (PHQ-9) total score, clinical remission rate and week achieved were evaluated over 6 weeks of treatment to assess clinical response referencing two different rTMS instruments (MagVenture; NeuroStar). Our survey included 247 participants from males (N=98) and females (N=149) with average baseline PHQ-9 scores of 21.7±4, classified as severe depression. Clinically rated remission rates of 72% were achieved in 3.1±1.0 weeks and associated with prior history of psychiatric hospitalization, suicide attempts and substance use disorder. Average baseline PHQ-9 scores decreased significantly over time with proportionately greater remission rates achieved for patients treated using the MagVenture over NeuroStar instrument. rTMS in applied clinical practice is efficacious over a wide range of settings and patients. Clinical response was related to severity of depression symptoms (e.g., prior hospitalization; suicide attempts) validating efficacy in critically ill groups. Clinical response may be impacted by rTMS instrument, magnetic field parameters or individual factors.

Diagnosis of substance use disorders and addictive behaviours are growing worldwide. It is timely to examine and collate literature on the nature of occupational therapy intervention in this field, to increase understanding of current practice and inform future directions. The purpose of this paper is to source and synthesise literature on occupational therapy interventions used in the treatment of people experiencing addiction.

Four databases were searched in August 2019. A total of 597 titles were screened, and 18 studies with varying methods met inclusion criteria. A narrative synthesis of the included literature was arranged into themes to summarise key findings.

Findings were grouped into three themes about occupational therapy provision to people experiencing addiction: single occupation focused intervention; skills training (including sub-themes on daily living skills and vocational skills); and establishing a community-based sober routine.

Further research on this topic should focus on efficacy of treatments and build on current findings to develop more rigorous research with appropriate sample sizes to support evidence-based practice.

This study presents a synthesis of how occupational therapy interventions have been used to treat people experiencing addiction issues. Findings indicate occupational therapy appears to fit well within addiction treatment and assert that occupational therapy is most supportive when interventions go beyond the teaching of skills alone to prioritise occupational engagement and client centred practice.