LOS ANGELES COUNTY HOMELESSNESS, MENTAL HEALTH AND ADDICTION RECOVERY RESOURCE DIRECTORY
Here are the vocabulary blocks to discuss addiction, mental health and homelessness, so you can join the conversation and or ask for your the services that you need.
1. Homeless Services Glossary
2. Addiction Glossary
3. Mental Health Glossary
1. Homeless Services Glossary:
Bridge (Reserved Crisis) Housing – Safe, reserved, 24‐hour emergency shelter to be utilized by eligible homeless individuals, identified through the Coordinated Entry System (CES). The intention of this emergency housing is to provide individuals with some stability, so that they can more easily maintain contact with their Housing Navigator, as they are assisted in their efforts to housing. Crisis Housing bed converts to a Bridge (Reserved Crisis) Housing bed if the program participant does not self-resolve their episode of homelessness within 14 days
Case Management – Case management is defined by the Case Management Society of America as “a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services” to meet individual needs. Case Management in the context of the Coordinated Entry System (CES) should be voluntary and client centered, with the goal of identifying strengths and client directed goals, while promoting “health, recognition, and well-being” (USICH, 2016). Case Managers in CES should ultimately focus on linking the client to a permanent housing resource and providing the necessary services needed to promote housing stability.
Chronically Homeless – 1. An individual who: a. Is homeless and lives in a place not meant for human habitation, a safe haven, or in an emergency shelter; AND b. Has been homeless and living or residing in a place not meant for human habitation, a safe haven, or in an emergency shelter continuously for at least twelve months or on at least four separate occasions in the last three years where those occasions cumulatively total at least twelve months; AND c. Can be diagnosed with one or more of the following conditions: substance use disorder, serious mental illness, developmental disability (as defined in section 102 of the Developmental Disabilities Assistance Bill of Rights Act of 2000 [42 U.S.C. 15002]), post-traumatic stress disorder, cognitive impairments resulting from brain injury, or chronic physical illness or disability; 2. An individual who has been residing in an institutional care facility, including a jail, substance abuse or mental health treatment facility, hospital, or other similar facility, for fewer than 90 days and met all of the criteria in paragraph (1) of this definition, before entering that facility; or 3. A family with an adult head of household (or if there is no adult in the family, a minor head of household) who meets all of the criteria in paragraph (1) of this definition, including a family whose composition has fluctuated while the head of household has been homeless.
Crisis Housing – An emergency shelter in the homeless coordinated entry system. Crisis Housing means any facility, the primary purpose of which is to provide temporary shelter for the homeless or to provide a bridge to permanent housing.
Emergency Shelter (ES) – Any facility whose primary purpose is to provide temporary shelter for homeless in general or for specific populations of the homeless.
General Relief (GR) – A county-funded program that provides financial assistance to indigent adults who are ineligible for Federal or State programs.
Homeless – An individual who belongs to one of the following categories: (1) An individual who lacks a fixed, regular, and adequate nighttime residence, meaning: (i) An individual with a primary nighttime residence that is a public or private place not designed for or ordinarily used as a regular sleeping accommodation for human beings, including a car, park, abandoned building, bus or train station, airport, or camping ground; (ii) An individual living in a supervised publicly or privately operated shelter designated to provide temporary living arrangements (including congregate shelters, transitional housing, and hotels and motels paid for by charitable organizations or by federal, state, or local government programs for low-income individuals); or (iii) An individual who is exiting an institution where he or she resided for 90 days or less and who resided in an emergency shelter or place not meant for human habitation immediately before entering that institution; (2) An individual who will imminently lose their primary nighttime residence, provided that: (i) The primary nighttime residence will be lost within 14 days of the date of application for homeless assistance; (ii) No subsequent residence has been identified; and (iii) The individual lacks the resources or support networks, e.g., family, friends, faith-based or other social networks, needed to obtain other permanent housing; (3) Any individual who: (i) Is fleeing, or is attempting to flee, domestic violence, dating violence, sexual assault, stalking, or other dangerous or life-threatening conditions that relate to violence against the individual that has either taken place within the individual's primary nighttime residence or has made the individual afraid to return to their primary nighttime residence; (ii) Has no other residence; and Produced by LAHSA – 5/2017 (iii) Lacks the resources or support networks, e.g., family, friends, faith-based or other social networks, to obtain other permanent housing. Homeless, defined by DPSS – Applicants/participants are considered homeless when they lack fixed and regular nighttime residences. If they share a residence with family or friends on a temporary basis; if they have a primary nighttime residence that is a supervised publicly or privately operated shelter designed to provide temporary living accommodations; if they reside in a public or private place not designed for or ordinarily used as a regular sleeping accommodation for human beings; if they have a need for housing in a commercial establishment (e.g. hotel/motel), shelter, publicly funded transitional housing or from a person in the business of renting properties, or received an eviction notice or notice to pay rent or quit.
Housing First – Housing First is an approach that offers permanent housing as quickly as possible for people experiencing homelessness, particularly for people with long histories of homelessness and co-occurring health challenges, while providing the supportive services people need to keep their housing and avoid returning to homelessness. The provider ensures that the supportive services that program participants need or want in order to achieve permanent housing and to increase income are offered, but are not required as a condition of housing, including links to mainstream programs or partner agencies (i.e. mental health services, substance abuse treatment, medical services, child care, etc.). Income, sobriety and/or participation in treatment or other services are voluntary and are not required as a condition for housing.
Housing Inventory Chart (HIC) – Consists of three housing inventory charts for: emergency shelter, transitional housing and permanent supportive housing.
Housing Navigation – Housing Navigation is the process by which homeless clients that have entered the CES system are provided ongoing engagement, document collection, and case management services in order to facilitate a match to an appropriate housing resource. In the context of CES, outreach workers, case managers, and other homeless service providers may provide housing navigation assistance.
Housing Navigator(s) – Housing Navigator is the client’s primary point of contact in CES, often a social worker, case manager, outreach worker, or volunteer. The primary function of the Housing Navigator is to: 1) assist clients in collecting necessary documents for housing applications, 2) accompany clients to housing appointments, and 3) assist clients in navigating the entire housing search and placement process.
Outreach – In the context of the CES system, Outreach is defined as the activity of engaging a homeless individual through the process of rapport building with the goal of linking that individual to a permanent housing resource. Outreach and engagement is an ongoing process that “involves creativity, flexibility, may take months or years, and involves establishing a relationship” to connect a client to services (Olivet, Bassuk, Elstad, Kenny, and Jassil, 2010). Outreach can be viewed as a “service in itself” and “a process of building a personal connection that may play a role in helping a person improve his or her housing, health status, or social support network” (Olivet, Bassuk, Elstad, Kenny, and Jassil, 2010). Outreach and engagement should be approached in a client-centered and voluntary manner that does not create any time constraints as to the alacrity in which the client voluntarily seeks permanent housing. Outreach workers should have the capacity to refer clients to resources and services such as Crisis & Bridge (Reserved Crisis) Housing and should regularly participate in case conferencing to ensure clients entering CES are matched to the appropriate permanent housing resource.
Permanent Housing (PH) – Community-based housing without a designated length of stay, which includes both Permanent Supportive Housing (PSH) and Rapid Rehousing (RRH). Examples of permanent housing include, but are not limited to, a house or apartment with a month-to-month or annual lease term or home ownership.
Permanent Supportive Housing (PSH) – Long-term, community-based housing that has supportive services for homeless persons with disabilities. This type of supportive housing enables the special needs of populations to live independently as possible in a permanent setting. Permanent housing can be provided in one structure or in several structures at one site or in multiple structures at scattered sites.
Rapid Rehousing (RRH) – A support intervention that uses a combination of case management, Housing Navigation, and short to medium term financial assistance to assist mid-range acuity homeless households identify and stabilize in tenant-based, scattered site, permanent housing.
Rent Reasonableness – The total rent charged for a unit must be reasonable in relation to the rents being charged during the same time period for comparable units in the private unassisted market and must not be in excess of rents being charged by the owner during the same period for comparable non-luxury unassisted units. Such determinations should consider: (a) location, quality, size, type, and age of unit; and (b) any amenities, housing services, maintenance and utilities to be provided by the owner. Comparable rents may be verified by using a market study, reviewing comparable units advertised for rent, or by obtaining written verification from the property owner documenting comparable rents for other units owned.
Social Enterprise - Social Enterprises are profit or non-profit organizations whose primary purpose is “common good to advance their social, environmental and human justice agendas.” Many Social Enterprises provide a supportive work environment for those with significant barriers to employment. Social Enterprises provide those with barriers to employment, including individuals experiencing homelessness, those reentering the community from incarceration, Veterans, disconnected youth, and those with disabilities, subsidized transitional employment combined with case management, supportive services and job readiness skills to prepare the hard-to-serve individual for unsubsidized, permanent employment.
Supportive Services – Services that may assist homeless participants in the transition from the streets or shelters into permanent or permanent supportive housing, and that assist persons with living successfully in housing.
Transition Age Youth (TAY) – An individual between the ages of 16 and 24.
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2. Addiction Glossary:
Abstinence: Not using drugs or alcohol.
Addiction: A chronic, relapsing disorder characterized by compulsive (or difficult to control) drug seeking and use despite harmful consequences, as well as long-lasting changes in the brain. In the past, people who used drugs were called “addicts.” Current appropriate terms are people who use drugs and drug users.
Agonist: A chemical substance that binds to and activates certain receptors on cells, causing a biological response. Oxycodone, morphine, heroin, fentanyl, methadone, and endorphins are all examples of opioid receptor agonists.
Amphetamine: A stimulant drug that acts on the central nervous system (CNS). Amphetamines are medications prescribed to treat attention deficit hyperactivity disorder (such as Adderall®) and narcolepsy.
Anabolic-androgenic steroids: Synthetic substances similar to the male hormone testosterone. Often known as “anabolic steroids.” They can promote muscle growth (anabolic effects) and produce changes in male sexual characteristics (androgenic effects) in both males and females.
Analgesics: A group of medications that reduce pain.
Anesthetic: A drug that causes insensitivity to pain and is used for surgeries and other medical procedures.
Antagonist: A chemical substance that binds to and blocks the activation of certain receptors on cells, preventing a biological response. Naloxone is an example of an opioid receptor antagonist.
Barbiturate: A type of CNS depressant sometimes prescribed to promote relaxation and sleep, but more commonly used in surgical procedures and to treat seizure disorders.
Basal ganglia: The area of the brain that plays an important role in positive forms of motivation, including the pleasurable effects of healthy activities like eating, socializing, and sex, and are also involved in the formation of habits and routines. These areas form a key node of what is sometimes called the brain’s “reward circuit.”
Benzodiazepine: A type of CNS depressant sometimes prescribed to relieve anxiety, panic, or acute stress reactions. Some benzodiazepines are prescribed short-term to promote sleep. Diazepam (Valium®) and alprazolam (Xanax®) are among the most widely prescribed benzodiazepine medications.
Brainstem: A group of brain structures that process sensory information and control basic functions needed for survival such as breathing, heart rate, blood pressure, and arousal.
Buprenorphine: An opioid partial agonist medication prescribed for the treatment of opioid addiction that relieves drug cravings without producing the high or dangerous side effects of other opioids.
Cannabidiol (CBD): A component of the marijuana plant without mind-altering effects that is being studied for possible medical uses.
Cannabinoid receptor: The receptor in the brain that recognizes and binds cannabinoids that are produced in the brain (anandamide) or outside the body (THC).
Cannabinoids: Chemicals that bind to cannabinoid receptors in the brain. They are found naturally in the brain (anandamide, 2-arachidonoylglycerol) and also in marijuana (THC and CBD). They are involved in a variety of mental and physical processes, including memory, thinking, concentration, movement, pain regulation, food intake, and reward.
Cannabis: Another name for the marijuana plant, Cannabis sativa.
Cardiovascular system: The system consisting of the heart and blood vessels. It delivers nutrients and oxygen to all cells in the body.
Central nervous system (CNS): The system consisting of the nerves in the brain and spinal cord.
Cerebellum: A part of the brain that helps regulate posture, balance, and coordination. It is also involved in the processes of emotion, motivation, memory, and thought.
Cerebral cortex: The gray matter that covers the surface of the cerebral hemispheres, whose functions include sensory processing and motor control along with language, reasoning, decision-making, and judgment.
Cerebral hemispheres: The right and left halves of the brain.
Cerebrum: The upper part of the brain consisting of the left and right hemispheres.
CNS depressants: A class of drugs that include sedatives, tranquilizers, and hypnotics. These drugs slow brain activity, making them useful for treating anxiety, panic, acute stress reactions, and sleep disorders.
Cognition (n): Of or relating to the act or process of thinking, understanding, learning, and remembering.
Cognitive-behavioral therapy (CBT): A form of psychotherapy that teaches people strategies to identify and correct problematic associations among thoughts, emotions, and behaviors in order to enhance self-control, stop drug use, and address a range of other problems that often co-occur with them.
Comorbidity: When two disorders or illnesses occur in the same person. Drug addiction and other mental illnesses or viral infections (HIV, hepatitis) are often comorbid. Also referred to as co-occurring disorders.
Contingency management: A treatment approach based on providing incentives to support positive behavior change.
Craving: A powerful, often overwhelming desire to use drugs.
Dependence: A condition that can occur with the regular use of illicit or some prescription drugs, even if taken as prescribed. Dependence is characterized by withdrawal symptoms when drug use is stopped. A person can be dependent on a substance without being addicted, but dependence sometimes leads to addiction.
Detoxification: A process in which the body rids itself of a drug, or its metabolites. Medically-assisted detoxification may be needed to help manage a person’s withdrawal symptoms. Detoxification alone is not a treatment for substance use disorders, but this is often the first step in a drug treatment program.
Dopamine: A brain chemical, classified as a neurotransmitter, found in regions of the brain that regulate movement, emotion, motivation, and reinforcement of rewarding behavior. Dopamine release in reward areas of the brain is caused by all drugs to which people can become addicted.
Drug abuse: An older diagnostic term that defined use that is unsafe, use that leads a person to fail to fulfill responsibilities or gets them in legal trouble, or use that continues despite causing persistent interpersonal problems. This term is increasingly avoided by professionals because it can perpetuate stigma. Current appropriate terms include: drug use (in the case of illicit substances), drug misuse (in the case of problematic use of legal drugs or prescription medications) and addiction (in the case of substance use disorder).
Drugged driving: Driving a vehicle while impaired due to the intoxicating effects of recent drug use.
Electronic cigarette: A battery-operated device that people use to inhale an aerosol, which typically contains nicotine, flavorings, and other chemicals; also called e-cigarette, e-cigs, e-vaporizers, or electronic nicotine delivery system.
Flashback: A sudden but temporary recurrence of aspects of a drug experience (including sights, sounds, and feelings) that may occur days, weeks, or even more than a year after using drugs that cause hallucinations.
Hallucinations: Sensations, sounds and/or images that seem real though they are not.
Hippocampus: An area of the brain crucial for learning and memory.
Hypothalamus: A part of the brain that controls many bodily functions, including eating, drinking, body temperature regulation, and the release of many hormones.
Illicit: Illegal or forbidden by law.
Impulsivity: A tendency to act without foresight or regard for consequences and to prioritize immediate rewards over long-term goals.
Injection drug use (IDU): The act of administering drugs by injection. Blood-borne viruses, like HIV and hepatitis, can be transmitted via shared needles or other drug injection equipment.
Intranasal: Taken through the nose.
Limbic system: Interconnected brain structures that process feelings, emotions, and motivations. It is also important for learning and memory.
Mental disorder: A mental condition marked primarily by disorganization of personality, mind, and emotions that seriously impairs the psychological or behavioral functioning of the individual. This is sometimes referred to as a mental health condition. Addiction is a mental disorder.
Methadone: A long-acting opioid agonist medication used for the treatment of opioid addiction and pain. Methadone used for opioid addiction can only be dispensed by opioid treatment programs certified by SAMHSA and approved by the designated state authority.
Motivational Enhancement Therapy: A counseling approach that uses motivational interviewing techniques to help individuals resolve any uncertainties they have about stopping their substance use. The therapy helps the person strengthen their own plan for change and engagement in treatment.
Naloxone: An opioid antagonist medication approved by the FDA to reverse an opioid overdose. It displaces opioid drugs (such as morphine or heroin) from their receptor and prevents further opioid receptor activation.
Naltrexone: A long-acting opioid antagonist medication that prevents receptors from being activated by other opioids. Naltrexone is used to treat alcohol and opioid use disorders.
Neonatal abstinence syndrome (NAS): A condition of withdrawal that occurs when certain drugs pass from the mother through the placenta into the fetus’ bloodstream during pregnancy causing the baby to become drug dependent and experience withdrawal after birth. The type and severity of a baby’s withdrawal symptoms depend on the drug(s) used, how long and how often the mother used, how her body broke down the drug, and if the baby was born full term or prematurely. NAS can require hospitalization and treatment with medication to relieve symptoms.
Neurobiology: The study of the anatomy, function, and diseases of the brain and nervous system.
Neuron (nerve cell): A unique type of cell found in the brain and throughout the body that specializes in the transmission and processing of information.
Neurotransmitter: A chemical compound that acts as a messenger to carry signals from one nerve cell to another.
Norepinephrine: A neurotransmitter that affects heart rate, blood pressure, stress, and attention.
Nucleus accumbens: A brain region in the ventral striatum involved in motivation and reward. Nearly all addictive drugs directly or indirectly increase dopamine in the nucleus accumbens, contributing to their addictive properties.
Opioid receptors: Proteins on the surface of neurons, or other cells, that are activated by endogenous opioids, such as endorphins, and opioid drugs, such as heroin. Opioid receptor subtypes include mu, kappa, and delta.
Overdose: An overdose occurs when a person uses enough of a drug to produce a life-threatening reaction or death.
Paranoia: Extreme and unreasonable distrust of others.
Partial agonist: A substance that binds to and activates a receptor to a lesser degree than a full agonist.
Pharmacodynamics: The way a drug acts on the body. This includes the drug’s interaction with its biological target and the resulting changes (such as activation or blocking of receptors), as well as the relationship between drug dosing and drug effects.
Pharmacokinetics: What the body does to a drug after it has been taken, including how rapidly the drug is absorbed, broken down, and processed by the body.
Pharmacotherapy: Treatment using medications.
Prefrontal cortex: The front part of the brain responsible for reasoning, planning, problem solving, and other higher cognitive functions. This area of the brain is not fully mature until adulthood, which confers greater vulnerability to drug use on the adolescent brain.
Prescription drug misuse: The use of a medication in ways or amounts other than intended by a doctor, by someone other than for whom the medication is prescribed, or for the experience or feeling the medication causes. This term is used interchangeably with “nonmedical” use, a term employed by many national drug use surveys.
Psychedelic drug: A drug that distorts perception, thought, and feeling. This term is typically used to refer to drugs with hallucinogenic effects.
Psychoactive: Having a specific effect on the brain.
Psychosis: Delusional or disordered thinking detached from reality; symptoms often include hallucinations.
Psychotherapeutics: Drugs that have an effect on the function of the brain and that are often used to treat psychiatric/neurologic disorders; includes pain relievers, tranquilizers, sedatives, and stimulants.
Receptor: A molecule located on the surface of a cell that recognizes specific chemicals (normally neurotransmitters, hormones, and similar endogenous substances) and transmits the chemical message into the cell.
Recovery: A process of change through which people with substance use disorders improve their health and wellness, live self-directed lives, and strive to reach their full potential.
Relapse: In drug addiction, relapse is the return to drug use after an attempt to stop. Relapse is a common occurrence in many chronic health disorders, including addiction, that requires frequent behavioral and/or pharmacologic adjustments to be treated effectively.
Remission: A medical term meaning that major disease symptoms are eliminated or diminished below a pre-determined harmful level.
Reward: Pleasurable feelings that reinforce behavior and encourage repetition.
Reward system (or brain reward system): A brain circuit that includes the ventral tegmental area, the nucleus accumbens, and the prefrontal cortex.
Risk factors: Factors that increase the likelihood of beginning substance use, of regular and harmful use, and of other behavioral health problems associated with use.
Route of administration: The way a drug is taken into the body. Drugs are most commonly taken by eating, drinking, inhaling, injecting, snorting, or smoking.
Self-medication: The use of a substance to lessen the negative effects of stress, anxiety, or other mental disorders (or side effects of their pharmacotherapy) without the guidance of a health care provider. Self-medication may lead to addiction and other drug- or alcohol-related problems.
Serotonin: A neurotransmitter involved in a broad range of effects on perception, movement, and emotions. Serotonin and its receptors are the targets of most hallucinogens.
Stigma: A set of negative attitudes and beliefs that motivate people to fear and discriminate against other people. Many people do not understand that addiction is a disorder just like other chronic disorders. For these reasons, they frequently attach more stigma to it. Stigma, whether perceived or real, often fuels myths and misconceptions, and can influence choices. It can impact attitudes about seeking treatment, reactions from family and friends, behavioral health education and awareness, and the likelihood that someone will not seek or remain in treatment.
Substance use disorder (SUD): A medical illness caused by disordered use of a substance or substances. According to the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), SUDs are characterized by clinically significant impairments in health, social function, and impaired control over substance use and are diagnosed through assessing cognitive, behavioral, and psychological symptoms. An SUD can range from mild to severe.
THC: Delta-9-tetrahydrocannabinol; the main mind-altering ingredient in marijuana.
Tolerance: A condition in which higher doses of a drug are required to achieve the desired effect.
Vaping: Inhaling the aerosol or vapor from an electronic cigarette, e-vaporizer, or other device.
Ventral striatum: An area of the brain that is part of the basal ganglia and includes the nucleus accumbens; dopamine is released here in the presence of salient stimuli and in response to physically rewarding activities such as eating, sex, and taking drugs, and this process is a key factor behind the desire to repeat the behaviors associated with these rewarding activities.
Ventral tegmental area: An area in the brainstem that contains dopamine neurons that make up a key part of the brain reward system, which also includes the nucleus accumbens and prefrontal cortex.
Withdrawal: Symptoms that can occur after long-term use of a drug is reduced or stopped; these symptoms occur if tolerance to a substance has occurred, and vary according to substance. Withdrawal symptoms can include negative emotions such as stress, anxiety, or depression, as well as physical effects such as nausea, vomiting, muscle aches, and cramping, among others. Withdrawal symptoms often lead a person to use the substance again.
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3. Mental Health Glossary:
ANTIDEPRESSANT: Medication used to treat depression and other mood and anxiety disorders.
ANTIPSYCHOTIC: Medication used to treat psychosis.
AUDITORY HALLUCINATIONS: Hearing something that is not real. Hearing voices is an example of auditory hallucinations.
BIPOLAR DISORDER: A disorder that causes severe and unusually high and low shifts in mood, energy, and activity levels as well as unusual shifts in the ability to carry out day-to-day tasks. (Also known as Manic Depression)
CHRONIC: Persisting for a long time or constantly recurring.
COGNITION: Conscious mental activities (such as thinking, communicating, understanding, solving problems, processing information and remembering) that are associated with gaining knowledge and understanding.
COGNITIVE IMPAIRMENT: Experiencing difficulty with cognition. Examples include having trouble paying attention, thinking clearly or remembering new information. (Also see cognition)
COGNITIVE REMEDIATION: Training that uses a variety of techniques including computer exercises and adaptive strategies to improve cognition. This therapy is designed to strengthen the underlying brain functions that help support cognitive skills such as memory, attention and problem solving.
COGNITIVE BEHAVIORAL THERAPY (CBT): CBT helps people focus on how to solve their current problems. The therapist helps the patient learn how to identify distorted or unhelpful thinking patterns, recognize and change inaccurate beliefs, relate to others in more positive ways, and change behaviors accordingly.
COGNITIVE BEHAVIORAL THERAPY FOR PSYCHOSIS (CBT-P): Cognitive Behavioral Therapy that specifically addresses the positive symptoms of psychosis (e.g., hearing voices).
COMMUNITY MENTAL HEALTH SERVICES BLOCK GRANT(CMHBG): Administered by the Substance Abuse and Mental Health Services Administration (SAMHSA), the CMHBG program makes funds available to all 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, and six Pacific jurisdictions to provide community mental health services. In 2014, the U.S. Congress added $24.8 million to the CMHBG and instructed SAMHSA to set these funds aside for evidence-based programs for early serious mental illness, including psychosis. The legislation also called for an NIMH and SAMHSA partnership to develop guidance for states regarding effective first episode psychosis treatment programs.
COMORBIDITY: The existence of two or more illnesses in the same person. These illnesses can be physical or mental.
CO-OCCURRING DISORDERS: People who have substance use disorders as well as mental health disorders are diagnosed as having co-occurring disorders, or dual disorders. This is also sometimes called a dual diagnosis. When a substance use disorder and a psychiatric disorder co-occur, they may differ in severity, and the severity of each can change over time. Compared to individuals who have a single disorder, those with a combination of disorders may experience more severe medical and mental health challenges and may also require longer periods of treatment.
COORDINATED SPECIALTY CARE (CSC) for first episode psychosis: CSC is a type of treatment that uses a team of specialists who work with the client to create a personal treatment plan. The specialists offer psychotherapy, medication management, CSC case management, family education/support, and supported employment/education, depending on the individual’s needs and preferences. The client and the team work together to make treatment decisions, involving family members as much as possible. The RAISE project tested the effectiveness of CSC for people with first episode psychosis.
CSC CASE MANAGER: This member of the CSC treatment team helps clients with problem solving and coordinates social services. The case manager has frequent in-person meetings with the clinician, the client, and the client’s family.
CSC TEAM LEADER: This member of the CSC treatment team coordinates the client’s treatment, leads weekly team meetings, oversees treatment plans and case review conferences, and develops transitions to and from the CSC program.
DELUSIONS: Beliefs that have no basis in reality.
DEPRESSION: Lack of interest or pleasure in daily activities, sadness and feelings of worthlessness or excessive guilt that are severe enough to interfere with working, sleeping, studying, eating and enjoying life.
DUAL DIAGNOSIS: Having a mental health disorder and an alcohol or drug problem at the same time.
DURATION OF UNTREATED PSYCHOSIS: The length of time between the beginning of psychotic symptoms and the beginning of antipsychotic treatment.
EARLY INTERVENTION: Diagnosing and treating a mental illness when it first develops.
EARLY TREATMENT PROGRAM (RAISE-ETP): One of the two studies that make up the RAISE (link to “What is RAISE?” page) research project. RAISE-ETP compares a coordinated specialty care program for first episode psychosis called NAVIGATE to care typically found in community clinics.
EVIDENCE-BASED PRACTICE: Treatments that are supported by clinical research.
FAMILY EDUCATION/SUPPORT: This part of coordinated specialty care teaches family and friends about first episode psychosis and helps them support the client’s recovery. Family and friends are involved in the client’s treatment as much as possible, and as long as it is consistent with the client’s wishes.
FIRST EPISODE PSYCHOSIS: The first time an individual experiences an episode of psychosis. Also see Psychosis.
FIRST EPISODE SCHIZOPHRENIA SPECTRUM: see First Episode Psychosis
HALLUCINATIONS: Hearing, seeing, touching, smelling or tasting things that are not real.
IMPLEMENTATION AND EVALUATION STUDY (RAISE-IES): One of the two studies that make up the RAISE research project. RAISE-IES evaluated the impact of a coordinated specialty care (CSC) treatment program called the Connection Program. It also developed manuals, tools, and materials that others may use to start their own CSC program.
INPATIENT: Health care treatment for someone who is admitted to a hospital (also see Outpatient).
INTERVENTION: An action intended to help treat or cure a condition.
IRT: see Individual Resiliency Training
INDIVIDUAL RESILIENCY TRAINING (IRT): One part of the NAVIGATE treatment program (see NAVIGATE). IRT promotes recovery by identifying client strength and resiliency factors, enhancing illness management, and teaching skills to help functional recovery in order to achieve and maintain personal wellness.
LAI: see Long-Acting Injectable (drugs)
LONG-ACTING INJECTABLE (drugs): A shot of medication administered once or twice a month. The shot is an alternative to taking a daily dose of medication.
MANIA: An abnormally elevated or irritable mood. Associated with bipolar disorder.
MANIC DEPRESSION: see Bipolar Disorder
MOOD DISORDERS: Mental disorders primarily affecting a person’s mood.
NATIONAL ALLIANCE ON MENTAL ILLNESS (NAMI): The nation’s largest grassroots mental health organization. NAMI is one of over 80 national nonprofit organizations that participate in the NIMH Outreach Partnership Program.
NATIONAL INSTITUTE OF MENTAL HEALTH (NIMH): The lead federal agency for research on mental disorders. NIMH is one of the 27 Institutes and Centers that make up the National Institutes of Health (NIH), the nation’s medical research agency. NIH is part of the U.S. Department of Health and Human Services (HHS).
NAVIGATE: A coordinated specialty care treatment program for people experiencing first episode psychosis. NAVIGATE is a team-based approach of treatment options that include medication management, case management, individual resiliency training, family psychoeducation, and supported employment/education. NAVIGATE is one of the two coordinated specialty care models tested as part of the RAISE research study. The other program is the Connection Program.
NEGATIVE SYMPTOMS: Symptoms of schizophrenia are often classified as positive or negative. Examples of negative symptoms that “take away” from life include social withdrawal, lost interest in life, low energy, emotional flatness, reduced ability to concentrate and remember. (Also see Positive Symptoms)
OnTrackNY: A coordinated specialty care treatment program in New York for youth and young adults experiencing first episode psychosis. OnTrackNY is based on the work of Lisa Dixon and her team on the RAISE Implementation and Evaluation Study (RAISE-IES), part of the RAISE research study.
OUTPATIENT: Health care treatment given to individuals who are not admitted to a hospital. (Also see Inpatient)
PHARMACOTHERAPY: Medication selection, dosing and management. Pharmacotherapy for first episode psychosis typically involves a low dose of a single antipsychotic medication and careful monitoring for side effects.
POSITIVE SYMPTOMS: Psychotic symptoms are often classified as positive or negative. Examples of positive symptoms that “add to” a person’s experiences include delusions (believing something to be true when it is not) and hallucinations (seeing, hearing, feeling, smelling or tasting something that is not real). (Also see Negative Symptoms)
PSYCHOSIS: The word psychosis is used to describe conditions that affect the mind, where there has been some loss of contact with reality. When someone becomes ill in this way it is called a psychotic episode. During a period of psychosis, a person’s thoughts and perceptions are disturbed and the individual may have difficulty understanding what is real and what is not. Symptoms of psychosis include delusions (false beliefs) and hallucinations (seeing or hearing things that others do not see or hear). Other symptoms include incoherent or nonsense speech, and behavior that is inappropriate for the situation. A person in a psychotic episode may also experience depression, anxiety, sleep problems, social withdrawal, lack of motivation and difficulty functioning overall.
PSYCHOEDUCATION: Learning about mental illness and ways to communicate, solve problems and cope.
PSYCHOSOCIAL INTERVENTIONS: Non-medication therapies for people with mental illness and their families. Therapies include psychotherapy, coping skills, training and supported employment and education services.
PSYCHOTHERAPY: Treatment of mental illness by talking about problems rather than by using medication. Treatment for first episode psychosis is based on cognitive behavioral therapy principles and emphasizes resilience training, illness and wellness management, and coping skills. Treatment is tailored to each client’s needs.
RAISE: Recovery After an initial Schizophrenia Episode (RAISE) is a large-scale research initiative that began with two studies examining different aspects of coordinated specialty care (CSC) treatments for people who were experiencing first episode psychosis. One study focused on whether or not the treatment worked. The other project studied the best way for clinics to start using the treatment program. The goal of RAISE was, and is, to help decrease the likelihood of future episodes of psychosis, reduce long-term disability, and help people to get their lives back on track so they can pursue their goals.
RAISE CONNECTION PROGRAM: See Connection Program
RAISE-ETP PROGRAM: See Early Treatment Program
RECOVERY: The process by which people with mental illness return or begin to work, learn and participate in their communities. For some individuals and their families, recovery means the ability to live a fulfilling and productive life.
SAMHSA: Substance Abuse and Mental Health Services Administration (SAMSHA) is the agency within the U.S. Department of Health and Human Services that leads public health efforts to advance the behavioral health of the nation. SAMHSA's mission is to reduce the impact of substance abuse and mental illness on America's communities.
SCHIZOAFFECTIVE DISORDER: A mental condition that causes both a loss of contact with reality (psychosis) and mood problems (depression or mania).
SCHIZOPHRENIA: A severe mental disorder that appears in late adolescence or early adulthood. People with schizophrenia may have hallucinations, delusions, loss of personality, confusion, agitation, social withdrawal, psychosis and/or extremely odd behavior.
SCHIZOPHRENIFORM DISORDER: Symptoms consistent with Schizophrenia but that last less than six months.
SUPPORTED EMPLOYMENT/EDUCATION (SEE): Part of coordinated specialty care, SEE services help clients return to work or school and achieve personal goals. Emphasis is on rapid placement in a work or school setting, combined with coaching and support to ensure success. Learn more at “What is supported education/employment and why is it important” on our Questions and Answers page.
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