Elizabeth Siantz

University of Utah | UOU · College of Social Work

Background Trust is essential for healthy, reciprocal relationships; creating safe environments; engaging in transparent interactions; successfully negotiating power differentials; supporting equity and putting trauma informed approaches into practice. Less is known, however, about the ways that trust-building may be at the forefront of considerati...

Background Transition age youth (TAY) experiencing mental illness, homelessness, and trauma face challenges in navigating the transition to adulthood. Age appropriate, trauma-informed support from peer specialists (PS) can assist TAY who have experienced trauma in navigating their transition to adulthood. Whether and how TAY PS are involved in trau...

Despite progress made under California’s Mental Health Services Act, limited access to care for cultural and linguistic minority groups remains a serious issue in community mental health. In this qualitative study we report findings from a large-scale community-level assessment that explored barriers to accessing care from the perspectives of multi...

Access and utilization of behavioral health services is a public health issue, yet disparities among racial/ethnic groups persist, resulting in fewer access points and lower utilization. Using pooled 2015 and 2016 California Health Interview Survey (N = 42,089) data of diverse adults, this study examines provider access points for behavioral health...

Background: Integrated behavioral health and primary care can improve the health of persons with complex chronic conditions. The Behavioral Health Integration and Complex Care Initiative (BHICCI) implemented integrated care across a large health system. Whether Behavioral Health Organizations (BHOs) and Federally Qualified Health Centers (FQHCs) i...

Introduction: Patient engagement in research can improve a health system's responsiveness to patient need, but patient experience with integrated care is not well understood. This qualitative study explores patient experience and provider perceptions of patient experience with the Behavioral Health Integration and Complex Care Initiative (BHICCI),...

Introduction: Practice coaches are skilled consultants who work in health care service delivery systems to make changes designed to improve patient outcomes, yet research is limited regarding their use to support integrated health care. This article describes the use of practice coaches in a large-scale effort to implement integrated care in the U...

Little is known about the contributions of practice facilitators in settings aiming to deliver integrated behavioral health and primary care. This scoping review identifies peer-reviewed articles that describe efforts to deliver integrated behavioral health care with the support of practice facilitators. Five databases were systematically searched...

This study examined peer-run organizations’ attitudes towards collaborating in health homes. Data were drawn from the 2012 National Survey of Peer-Run Organizations. Multinomial logistic regression modeled the association between organizational willingness to participate in a health home and salient factors. Current efforts (OR = 5.05; p < 0.05), p...

This qualitative study explored the experiences of persons staying at two peer respites through interviews with 27 respite guests near the end of their stay and at 2–6 months following their stay. Trained peer interviewers conducted baseline and follow-up interviews. Peer respites can be beneficial spaces within the mental health system for guests...

This qualitative study explored peer provider experiences working in newly integrated mental health and primary care pilot programs within a large public mental health system. Nineteen peer providers participated in semistructured interviews that focused on experiences delivering care within integrated teams. Interviews were analyzed using constant...

This article reports how a large Medi-Cal managed care plan addressed challenges in accessing health care for approximately 7,000 enrollees with multiple chronic conditions through a project known as the Behavioral Health Integration and Complex Care Initiative. The initiative increased staffing for care management, care coordination, and behaviora...

Little is known about the involvement of peer providers in integrated behavioral health teams. This study asks where peer providers fit within integrated care teams in Los Angeles County. Social network analysis combined with qualitative fieldwork was used to understand the network positions of peer providers in 14 integrated pilot programs. Four p...

Assertive community treatment (ACT) has the potential to serve as a medical home for adults with serious mental illness, a population that experiences some of the most significant health disparities in the United States. Using site visit methodology, the authors describe partnerships that were created between five ACT programs and federally qualifi...

Peer providers are integral to Full Service Partnerships (FSPs), which are team-based mental health service models. Peer providers use principles of recovery to engage clients, but FSPs can vary in their recovery orientation. Whether and how peer recovery orientation reflects the organizational environments of FSPs is unclear. This qualitative stud...

Background: Colorectal cancer is the second leading cause of cancer-specific death in the USA. Evidence suggests people with mental illness are less likely to receive preventive health services, including cancer screening. We hypothesized that mental illness is a risk factor for non-adherence to colorectal cancer-screening guidelines. Methods: W...

People living with serious mental illness are at elevated risk for chronic diseases compared with those in the general population. Whether integrated care for this population would be most accessible in primary care or mental health settings is unclear. The cross-sectional study described in this article used descriptive analyses and multinomial lo...

Objective Peer providers are essential to the delivery of recovery-oriented mental health services, but little is known about their roles in delivering integrated mental health and primary care services. This study examines how peer-based services are implemented in newly integrated behavioral health care settings in Los Angeles County, California....

Background Ventilator-associated respiratory infections (tracheobronchitis, pneumonia) contribute significant morbidity and mortality to adults receiving care in intensive care units (ICU). Administration of broad-spectrum intravenous antibiotics, the current standard of care, may have systemic adverse effects. The efficacy of aerosolized antibioti...

People living with serious mental illness (SMI) have shorter life expectancies than the general population. We examined how contextual factors influence the physical health of this population. We conducted interviews, focus groups, and participant observations with stakeholders from six behavioral health organizations. We found that consumers' avoi...

Objective. People with SMI experience poor physical health and many years of life lost compared to the general population, but are less likely to use primary care health services needed to promote optimal health. Many factors are known to impede the use of physical health services among those with SMI that result from the separation of physical and...

Purpose: To examine practices, barriers, and recommendations for addressing the physical health of racially and ethnically diverse people with serious mental illness (SMI). Methods: Semi-structured interviews and participant observations were conducted with 21 administrators and 25 clinicians representing six mental health care organizations. Da...

Introduction: Stigma and discrimination against individuals living with serious mental illness (SMI) result in decreased life opportunities, loss of independent functioning, and can have negative consequences for personal relationships, education, employment, and stable housing. Recovery centers are physical entities offering services and resources...

People with serious mental illness die, on average, 25 years earlier than the general population. This disparity is largely due to treatable medical conditions that remain unaddressed due to factors at the client, treatment, provider, clinic, and system levels of health and mental health service delivery. This paper describes the development, initi...

Diabetes is a leading cause of death nationally and disproportionately affects people with serious mental illness (SMI). Patient-provider collaboration in diabetes management planning is associated with improved health among individuals with diabetes, but little is known about the effects of such a plan on the health of people with diabetes and SMI...

Background: People living with serious mental illness (SMI) are vulnerable to disparities in health and health service use and experience on average 25 years more of lost life compared to the general population. Some minorities with SMI have higher rates of diabetes and obesity compared to non-Hispanic whites with SMI, but are less likely to utiliz...

The authors report a process evaluation that used rigorous qualitative methods consistent with best practice to assess the development and impact of a nascent recovery center in the New York City area. The center successfully delivered services that focused on helping increasing numbers of consumers achieve educational and functional improvements....

Objectives: Racial and ethnic minorities with serious mental illness (SMI) experience disparities in health and healthcare resulting from high medical need, inadequate access to primary care, and poor quality of care compared to their white counterparts. The aims of this qualitative study are to (1) examine sociocultural elements in the provision a...