Revised 1/11/2016

HSSP 115b Syllabus

Perspectives on Behavioral Health: Alcohol, Drugs, and Mental Health

Block N – Tuesdays & Thursdays 2:00-3:20 pm

Heller School, Classroom G2

1

HSSP 115b Spring 2016

Revised 1/11/2016

INSTRUCTOR: Sharon Reif, Ph.D.

, Heller-Brown 259, 781-736-3924

COURSE ASSISTANT: Wanda Rifkin, , 781-736-3769

TEACHING ASSISTANT: Jenn Miles, , Heller-Brown 265

OFFICE HOURS

Mondays 2:00-4:00 or by appointment (Jenn Miles, room 265)

Wednesdays 3:30 -4:30pm or by appointment (Dr. Reif, room 259)

COURSE OVERVIEW

This is a broad course on behavioral health, with a primary focus on substance use and mental disorders in the United States. The course will include several focus areas relevant to substance use and mental disorders:

  • Overview, including understanding the disorders themselves, history, theoretical perspectives and science (Sessions2-7)
  • Societal impacts, with a consideration of overall prevalence, specific populations, consequences and effects of substance use and mental disorders (Sessions 8-11)
  • Prevention, treatment and recovery (Sessions 12-19)
  • Policy issues and approaches (Sessions 20-24).

We will have several guest lecturers including representatives from organizations for people with mental and substance use disorders. Several classes are devoted to participatory debates and focused discussion of specified topics.

Learning objectives for this course include knowledge and core skill development. It is expected at the end of this course you will have:

  • An in-depth understanding of the complexity of mental health, substance use, and mental and substance use disorders
  • Ability to critically think about policy issues relevant for people with substance use and mental disorders.
  • Research and writing skills sufficient to identify a topic and prepare a research paper and give a very brief presentation on your findings.

Course requirements, detailed below, include readings and class participation, in-class quizzes, brief “thoughts and questions” (T&Qs), and a research paper (submitted in several sections).

Success in this 4-credit course is based on the expectation that students will spend a minimum of 9 hours of study time per week in preparation for class (readings, T&Qs, papers, preparation for in-class quizzes and assignments, research, and so on).

COURSE REQUIREMENTS AND GRADING

10%Attendance

  • Please do not come to class if sick. I allow several missed days of class for full attendance.
  • If you have excused absences due to athletics or other obligations, I must have a formal letter from your coach (or equivalent) indicating your participation.

25%Active participation

  • Be generally engaged in all classes and prepared to share your comments or questions about readings assigned for that day. I will often start class by calling on several students.
  • Actively participate in several classes devoted to policy debate, or other discussion.
  • Briefly discuss your research paper.
  • Complete at least 4 “Thoughts and Questions,” (“T&Qs”) – 1 for each group (column) below.
  • Submitted on LATTE by 8am the day before class.
  • Briefly write about something interesting or confusing about the readings for this class.
  • These are intended to be brief. Although not graded, please write in full sentences for clarity.
  • We will review the T&Qs before class and select a few to use for discussion or comment in class. You will not be identified when we do this.

T&Q 1 / T&Q 2 / T&Q 3 / T&Q 4
Feb 9 / Feb 25 / Mar 3 / Mar 31
Feb 11 / Mar 1 / Mar 22 / Apr 5
Mar 10 / Apr 7
Mar 29

10%Quizzes (2 quizzes, 5% of class grade each)

  • 15-20 minutes each, and may include multiple choice, true/false, and/or short answer questions.
  • No make-ups.

15%Short in-class essays (2 essays, 7.5% of class grade each)

  • 30 minutes each.
  • No make-ups.

40%Research paper

  • In-depth discussion of an area touched on in the course: choose a special population, another system (such as education or criminal justice) or a current policy, and prepare a detailed paper on that topic. Sample titles and papers will be distributed in class.

The paper will be graded in parts, as follows, with a full final paper due at the end of the semester. Each part will be graded and returned to you. It is expected that you will revise those sections when you include them in the full paper. A well-written paper is expected, and your final grade will reflect the quality of writing.

  • Summary of your topic (2-3 sentences) and formal 1-2 page outline. For the outline, you should indicate the subtopics that you plan to cover for the paper. This is not a graded part of the assignment, but you may not start your paper until I have approved your topic. Due February 9, required but not graded
  • Part 1: Background. This should cover “what is it” for your topic. Describe the disorder, population, system, policy or problem to solve. Discuss history or theories as appropriate. Include appropriate citations in-text and a bibliography. Due March 8, about 3-5 pages, 10% of class grade
  • Part 2: Prevention, Treatment and/or Policy. This should cover the “what to do about it” for your topic. Include appropriate citations in-text and a bibliography. Due March 29, about 3-5 pages, 10% of class grade
  • Final Paper: The final paper must be complete, including an introduction, parts 1 and 2, a conclusion, and a bibliography. Be sure the sections flow together. Use headings and sub-headings for clarity. Due May 2, 10-15 pages, 20% of class grade
  • Details and Formatting
  • 10-15 pages (undergraduates) or 15-18 pages (graduate students)
  • Formatting: 1.5 line spacing, 11 pt font, 1 inch margins.
  • Citations: 10-15 references, and the majority of those should be from academic journals or books. Citations within the text should use APA style with the full citation in the bibliography at the end. The bibliography does not count toward the page limits.
  • Late assignments will result in a lower grade.
  • You are expected to use Turn-It-In to review your paper prior to submission, to evaluate for and address potential plagiarism. We will do the same.

KEY DATES:

Quizzes and essays may not be made up. Please plan your vacation travel accordingly. If you are excused due to sports or other activities, you must see me prior to missing any assignments. Late paper assignments will result in a lower grade.

Quiz #1 / Feb 2
Quiz #2 / Mar 24
Essay #1 / Feb 23
Essay #2 / Apr 14
Paper topic and outline / Feb 9, 5pm
Paper – Part 1 / Mar 8, 5pm
Paper – Part 2 / Mar 29, 5pm
Final paper / May 2, 11:55pm
In-class brief discussion of paper / Apr 14, 19

CLASSROOM ETIQUETTE

  • Cell phones off and away.
  • Laptops permitted during lecture portions of class, for note-taking only. Please be respectful of the presenters and your fellow classmates.
  • No laptops to be used during class discussion time.
  • Please do not attend class if you are ill.
  • Come to class prepared and on time.
  • Class is participatory; please be aware you may be called upon.

DISABILITY STATUS

If you are a student with a documented disability on record at Brandeis University and wish to have a reasonable accommodation made for you in this class, please see me immediately.

ACADEMIC INTEGRITY

Academic integrity is central to the mission of educational excellence at Brandeis University. You are expected to be honest in all of your academic work. Please consult Brandeis University Rights and Responsibilities for all policies and procedures related to academic integrity. Students may be required to submit work to TurnItIn.com software to verify originality and I may do the same. Allegations of academic dishonesty will be forwarded to the Director of Academic Integrity. Sanctions for academic dishonesty can include failing grades and/or suspension from the university. Citation and research assistance can be found at LTS - Library guides.

Each student is expected to turn in work that he or she completed independently, unless specifically noted otherwise. If you are in doubt about the instructions for any assignment in this course it is your responsibility to ask for clarification.

Plagiarism:It is unacceptable to use information from other sources without proper citation, whether those sources are published or unpublished (e.g., web sites). Assignments that appear to be instances of plagiarism may be returned to the student for revision, considered incomplete, or reported to the university, at the discretion of the instructor. Such behavior will also be considered a serious deficiency in grading pertaining to the particular assignment.

If you are unsure about what constitutes plagiarism it is your responsibility to ask for clarification.LTS has resources to help you understand what constitutes academic integrity and plagiarism:

OTHER RESOURCES

Writing assistance: The University provides writing assistance if you need help with this component of

assignments: strongly encourage you to use this resource since clarity and organization of writing will affect grading.All written materials at any point in your education or career will be better for having someone else read it.

Counseling services: The University provides counseling services through the Psychological Counseling Center: (781) 736-3730 (M-F, 9-5); 781-239-8312 (24 hour),

COURSE TOPICS AND READINGS - OVERVIEW

  • Readings are to be completed before class on that date.
  • Check for page numbers – some readings are sub-sections of the named chapter. If no page number, read the whole chapter.
  • All materials other than the 2 texts listed below are available via LATTE.
  • LATTE will always be the most up to date regarding class assignments. Please use LATTE to determine your work for each class. The readings below are current as of this date, but may be updated over the semester.

TEXTS

Abadinsky H. Drug Use and Abuse: A Comprehensive Introduction, 8th Edition. Belmont, CA: Wadsworth CENGAGE Learning, 2012. The 8th edition is preferred for more updated information, but the 7th edition may be used. Please see list of Abadinsky readings on LATTE for 7th edition readings. A copy of the 7th edition is on reserve at the library.

Mechanic D, McAlpine DD, Rochefort DA. Mental Health and Social Policy: Beyond Managed Care, 6th Edition. Boston: Pearson, 2014. Do not use earlier editions of this text. A copy of the 6th edition is on reserve at the library.

COURSE TOPICS AND READINGS – DETAILS

1. Thursday, January 14: Introduction to course

  • No readings

2. Tuesday, January 19: Symptoms, disorders, biopsychosocial model

  • Edberg. Essentials of Health Behavior. Sudbury MA: Jones & Bartlett, 2007. Ch 1: The links between health and behavior, pp.3-9 (LATTE)
  • Sharma. Foundations of Health Promotion. Burlington, MA: Jones and Bartlett Learning, 2013. Ch 1: Concept of health; Concept of mental health and mental illness, pp.2-5. (LATTE)
  • Mechanic, Ch 1: Defining mental illness, pp.1-4
  • Mechanic, Ch 2: What are mental health and mental illness? (full chapter)
  • Abadinsky, Ch 1: An introduction to drug use and abuse pp. 1-8
  • Mechanic, Ch 6: Illness behavior and selection into care, pp.145-153

3. Thursday, January 21: Introduction to mental health; Introduction to the Library

  • Sharma, Ch5: Understanding Major Psychotic Disorders, pp.91-96 (LATTE)
  • Sharma, Ch 6: Understanding Mood, Anxiety, and Personality Disorders, pp.107-121 (LATTE)
  • National Institute on Mental Health (NIMH). Depression. (LATTE)
  • National Institute on Mental Health (NIMH). Schizophrenia. (LATTE)

Optional Reading:

  • Schwartz, Alan. “The Selling of Attention Deficit Disorder.” The New York Times 14 December 2013.

4.Tuesday, January 26: Introduction to substance use disorders

  • Abadinsky, Ch 3: Depressants, pp.39-49 (heroin/opiates), pp.55-63 (alcohol)
  • Abadinsky, Ch 4: Stimulants, pp.69-80 (cocaine)
  • Abadinsky, Ch 5: Hallucinogens, Marijuana, Inhalants, Prescription Drugs, pp.110-114 (marijuana), pp.116-121 (prescription drugs)
  • Abadinsky, Ch 6: Section on Stages of Use, pp. 137-140

5. Thursday, January 28: Policy debate: Drinking age

  • Class participation – instructions to be provided
  • BaborAlcohol,Ch 9: Regulating the physical availability of alcohol, pp.139-141 (LATTE)
  • “Keeping Legal Drinking Age at 21 Saves 900 Lives Yearly: Study.” Huffington Post. 24 February 2014. (LATTE)
  • Facts Sheet: Age 21 Minimum Legal Drinking Age. Centers for Disease Control and Prevention. 24 March 2014. (LATTE)

6. Tuesday, February 2: History and theories

***QUIZ #1***

  • Mechanic, Ch 3: A brief history of mental health policy in the United States (full chapter)
  • Rochefort DA. From Poorhouses to Homelessness: Policy Analysis and Mental Health Care, 2nd ed. Westport, CT: Auburn House, 1997. Ch 2: U.S. Mental Health Care – the first three centuries, pp.17-32 (LATTE)
  • Abadinsky, Ch 8: History of Drug Use and Drug Legislation, pp.190-194, pp.201-210, pp.214-216, pp.219-224, (skim other sections of the chapter)
  • Mechanic, Ch 5: Controlling Mental Illness: pp.102-103, pp.108-119
  • Abadinsky, Ch 6: Psychology and Sociology of Drug Use and Abuse, pp.125-136 (skim pp. 127-131); pp.140-150

Optional Reading:

  • Hinshaw SP, Cicchetti D. Stigma and mental disorder: conceptions of illness, public attitudes, personal disclosure, and social policy. Dev Psychopathol. 2000; 12(4):555-98 (LATTE)
  • Waters E (2010). Americanization of Mental Illness. New York Times Magazine. 10Jan2010(LATTE)

7. Thursday, February 4: Overview of underlying science

  • Mechanic, Ch 5: Genes, environment and the brain, pp.103-108
  • Abadinsky, Ch2: Biology of psychoactive substances, pp. 21-36
  • BrainExplorer.org:
  • Depression:
  • PTSD:
  • Schizophrenia:

Optional Reading:

  • Leshner AI. (1997). Addiction is a brain disease and it matters. Science, 278: 45-47

8. Thursday, February 9: Epidemiology, co-occurring disorders

*** PAPER OUTLINE DUE***

  • Mechanic, Ch 4: Psychiatric epidemiology
  • Goode, Ch 6: How Do We Know It’s True – Methods of Research, pp.149-154 (LATTE)
  • Breslau J, Aguilar-Gaxiola S, Kendler K, Su M, Williams D, and Kessler RC. Specifying race-ethnic differences in risk for psychiatric disorder in a USA national sample. Psychological Medicine. 2006; 36:57-68 (LATTE)
  • Abadinsky, Ch 1: An Introduction to Drug Use and Abuse, pp.13-18
  • National Institute on Drug Abuse. DrugFacts: Nationwide Trends.June 2015:
  • Comorbidity: Addiction and Other Mental Illnesses. NIDA publication, December 2008, revised 2010 (LATTE)

Optional Reading:

  • Zweben JE. Special Issues in Treatment: Women. In Reis RK, Fiellin DA, Miller SC, Saitz R (Eds.), Principles of Addiction Medicine, 4th Edition. Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins, 2009. Ch 34, pp. 465-477 (LATTE)
  • Warner LA, Valdez A, Vega WA, de la Rosa M, Turner JR, Canino G. Hispanic drug abuse in an evolving cultural context: An agenda for research. Drug Alcohol and Dependence. 2006; 84S:S8-S16 (LATTE)

9. Thursday, February 11: Consequences

  • Mechanic, Ch 1: The consequences of mental illness AND The consequences of behavioral health disorders in childhood, pp.4-10
  • Katon W. The impact of depression on workplace functioning and disability costs. American Journal of Managed Care. 2009; 15:S322-S327 (LATTE)
  • Insel TR. Assessing the economic costs of serious mental illness (editorial). American Journal of Psychiatry. June 2008, 165(6):663-665 PDF document (LATTE)
  • Abadinsky, Ch 1: Drug use and crime/violence, pp. 8-13
  • Choose one:
  • Babor et al. Alcohol: No Ordinary Commodity, 2nd edition. New York: Oxford University Press, 2010.Ch 4: The global burden of alcohol consumption, pp.43-70 (LATTE)
  • Babor et al. Drug Policy and the Public Good. New York: Oxford University Press, 2010. Ch 4: Harms associated with illicit drug use, pp.47-61 (LATTE)

Optional Reading:

  • Yohannes AM, Willgoss TG, Baldwin RC, Connolly MJ. Depression and anxiety in chronic heart failure and chronic obstructive pulmonary disease: prevalence, relevance, clinical implications and management principles. International Journal of Geriatric Psychiatry. 2009; Epub: DOI: 10.1002/gps.2463 (LATTE)
  • Gonzalez JS, Peyrot M, Mccarl LA, et al. Depression and diabetes treatment nonadherence: A meta-analysis. Diabetes Care 31:2398–2403, 2008 (LATTE)
  • Abadinsky, Ch 10: Drug Laws and Drug Enforcement, pp. 260-286
  • Abadinsky, Ch 9: Drug Trafficking, pp.227-257

[MIDTERM RECESS]

10. Tuesday, February 23: Behavioral health in media

***IN-CLASS ESSAY #1***

  • Class participation: Find example of mental or substance use disorders as portrayed in the popular media (e.g., movies, books, TV, magazines, etc.). Describe and discuss whether and how it is accurate/inaccurate; likely impact on public perception.
  • No readings.

11. Thursday, February 25: Violence and behavioral health/legal issues

Guest lecturer: Kenneth Appelbaum, M.D., University of Massachusetts Medical Center

  • Mechanic, Ch 11: Mental illness, the community and the law
  • McGinty – from LATTE
  • Choe JY, Teplin LA, Abram KM. (2008). Perpetration of violence, violent victimization, and severe mental illness. Psychiatric Services, 59(2): 153-164. (LATTE)
  • Treatment Advocacy Center Backgrounder. Violent Behavior: One of the Consequences of Failing to Treat Individuals with Severe Mental Illnesses. Treatment Advocacy Center. April 2011. (LATTE)

Optional Reading:

  • Appelbaum KL, Appelbaum PS. Forensic Psychiatry. In: Goldman, HH, editor. Review of General Psychiatry, Fourth Edition. Appleton and Lang, 1995, pp. 530-539 (LATTE)
  • Clark HW and Bizzell AC. Ethical issues in addiction practice in ASAM Principles of Addiction Medicine, Fourth Edition. Philadelphia: Wolters Kluwer/Lippincott Williams and Wilkens, 2009. (LATTE)

12. Tuesday, March 1: Prevention and early intervention

  • Abadinsky, Ch 7: Preventing and treating drug use, pp.153-165
  • World Health Organization (WHO) Summary Report: Prevention of Mental Disorders – Effective Interventions and Policy Options. WHO and Department of Mental Health and Substance Abuse, 2004, pp.16-51.

(LATTE)

13. Thursday, March 3: Mental health consumers from the National Alliance on Mental Illness (NAMI)

In Our Own Voice – Guest speakers

VISIT website of National Alliance on Mental Illness (NAMI). (LATTE)

14. Tuesday, March 8: Prevention – Design an approach

*** PAPER PART 1 DUE***

  • Class participation: Small-group work to identify a specific problem and design a prevention approach for it. Details of the assignment will be provided at the previous class.
  • No readings.

15. Thursday, March 10: Tobacco/nicotine

Guest lecturer: Deborah McLellan, PhD, Dana-Farber Cancer Center

  • Abadinsky, Ch 4: Stimulants (nicotine), pp.88-93
  • Sweanor D and Yach D. (2013). Guest Editorial: Looking for the next breakthrough in tobacco control and health. South African Medical Journal, 103(11):810-811. (LATTE)
  • Saloojee Y and Yach D. (2013). Smoke, fire and mirrors: The e-cigarette debate. South African Medical Journal, 103(11):818-819. (LATTE)

Stanford University has recently put together an extensive online collection of e-cigarette ads (some comparing them to cigarettes): Please look through the site (or elsewhere), bring your favorite ad to class, and be prepared to introduce it and some of the themes the ad might address.

Optional Reading:

  • Ksir C et al. Drugs, Society and Human Behavior, 12thed. Boston: McGraw-Hill, 2008. Ch 10: Tobacco, pp.236-258. (LATTE)

16.Tuesday, March 15: Treatment overview

  • Merrick EL, Reif S. Services in an era of managed care. In Lubotsky BL (ed.). Women’s Mental Health Services, 2010, pp. 214-217 (rest of chapter is optional] (LATTE)
  • Sharma, Treatment settings, Ch 8: pp162-165 (LATTE)
  • Mechanic, Ch 1: The importance of mental health professions, pp.10-13
  • Mechanic, Ch 9: Mental health professions and practice, pp.219-226, pp.234-239 (skim rest of chapter)
  • Mechanic, Ch 10: Redesigning community care programs, pp. 265-270
  • Levin, Ch 11: Treatment system for alcohol and drug disorders (LATTE)
  • Tomes N. The patient as a policy factor: a historical case study of the consumer/survivor movement in mental health. Health Affairs (Millwood). 2006 May-Jun; 25(3):720-9. (LATTE)

Optional Reading: