Cultural considerations for substance use and substance use disorders among Black men.

There are complex cultural considerations for understanding, assessing, and treating substance use disorders (SUD) among Black men, from the initiation of substance use through SUD-related outcomes. This narrative review provides insight into some of these factors, including the individual, interpersonal, and community-level risk and protective factors (e.g., family and social roles, religiosity, racism and discrimination, exposure to trauma and adversity) underlying relative risk for substance use and disparities in SUD-related outcomes. This article also highlights the ways that public attitudes and policies related to substance use have contributed to ongoing inequities in SUD treatment access for Black men. Recommendations for clinical research and practice include increasing focus on measurement equivalence, creating pathways for access to community-based and specialty treatment, and providing services that are culturally affirming, relevant, and appropriate. Comprehensive efforts are needed to reduce SUD-related inequities and promote positive well-being among Black men and their communities.

I feel frozen: Client perceptions of how posttraumatic stress disorder impacts employment.

Objective: There is evidence that posttraumatic stress disorder (PTSD) is a hidden barrier to employment among individuals with serious mental illnesses (SMI) among whom PTSD is highly prevalent. This study aimed to explore how PTSD interferes with achieving employment outcomes among persons with SMI. Methods: Participants included 119 individuals with SMI and co-occurring PTSD receiving Supported Employment services. Responses to the question, "In what ways are PTSD symptoms interfering with your work during the past month?" were analyzed. Results: Six themes emerged: (a) I don't like being around people, (b) I feel frozen and unable to get started, (c) troubling negative affect, (d) mind is scattered and all over the place, (e) feeling fatigued all the time, and (f) flashbacks and triggers can happen whenever. Conclusions and Implications for Practice: Findings provide insight into how PTSD symptoms impact work outcomes and suggest that there is a need for Supported Employment providers to screen clients for trauma exposure to identify those in need of additional support in order to improve work outcomes. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Trauma Exposure and Prolonged Grief Disorder Among Persons Receiving Community Mental Health Services: Rates and Correlates.

BACKGROUND: Persons with serious mental illnesses (SMIs) are at increased risk for exposure to trauma and posttraumatic stress disorder (PTSD). Prolonged Grief Disorder (PGD) may also impact this population but has been seldom studied. AIMS: The present study investigated the rate of both PTSD and PGD among clients receiving community mental health services, and the clinical correlates of co-occurring PTSD/PGD. METHODS: Trauma history, PTSD and PGD were assessed among 536 individuals receiving community mental health services (Study 1). A subsample of 127 individuals from Study 1 who met DSM-5 criteria for PTSD based on diagnostic interview completed measures of psychiatric symptoms (Study 2). RESULTS: In Study 1, 92.4% of participants receiving community mental health services had experienced a traumatic event, 49.6% met criteria for probable and provisional PTSD, 14.7% scored positive for probable PGD, and 11.9% met criteria for probable and provisional PTSD as well as probable PGD. In Study 2, participants meeting diagnostic DSM-5 criteria for PTSD and probable PGD had more self-reported PTSD symptoms, but did not differ on other outcomes. CONCLUSIONS: Findings highlight the need for trauma informed services including grief counseling for persons with SMI.