{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T09:09:08Z","timestamp":1784279348472,"version":"3.55.0"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:00:00Z","timestamp":1780963200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Emergency departments are vital safety-net resources for adults seeking mental health treatment. Frequent mental health emergency department use has been associated with homelessness and alcohol use. However, little of this research has been conducted in rural settings, particularly in Northern Appalachia. Therefore, this program-level study aimed to describe the relationship between recent mental health emergency department use, homelessness, and alcohol use in intake survey data from one outpatient mental health clinic. Participants were 1,293 adults seeking treatment between June 2020 and August 2022. On average, participants reported using an emergency room for a psychiatric or emotional problem less than one time in the past 30 days. Nights spent homeless were statistically significantly positively associated with recent mental health emergency department use. Additionally, those who used alcohol daily or almost daily demonstrated a statistically significant greater frequency of mental health emergency department use compared with adults who did not use alcohol within the past 30 days. Future social work research should replicate this study with a larger, multisite, random sample of mental health treatment\u2013seeking adults in rural Northern Appalachian settings.<\/jats:p>","DOI":"10.1093\/hsw\/hlag025","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T11:27:51Z","timestamp":1778585271000},"page":"223-229","source":"Crossref","is-referenced-by-count":0,"title":["Mental Health Emergency Department Use among Treatment-Seeking Adults in a Rural Northern Appalachian Clinic: The Role of Homelessness and Alcohol Use"],"prefix":"10.1093","volume":"51","author":[{"given":"Michael L","family":"Clarkson-Hendrix","sequence":"first","affiliation":[{"name":"State University of New York at Fredonia Michael L. Clarkson-Hendrix, PhD, MSW, is associate professor of social work, Department of Social Work & Criminal Justice, and lead evaluator, Fredonia Program Evaluation Center, , W381 Thompson Hall, 280 Central Avenue, Fredonia, NY 14063, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cassidy","family":"Heinen","sequence":"additional","affiliation":[{"name":"Fredonia Program Evaluation Center Cassidy Heinen, MSW, is project aide, , Fredonia, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Kearns","sequence":"additional","affiliation":[{"name":"Fredonia Program Evaluation Center Kevin Kearns, PhD, is professor, Department of Communication Disorders and Sciences, and director, , Fredonia, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,9]]},"reference":[{"key":"2026071704522128400_hlag025-B1","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1080\/10550887.2020.1736757","article-title":"Alcohol use and risk of suicide: A systematic review and meta-analysis","volume":"38","author":"Amiri","year":"2020","journal-title":"Journal of Addictive Diseases"},{"key":"2026071704522128400_hlag025-B2","author":"Appalachian Regional Commission","year":"."},{"key":"2026071704522128400_hlag025-B3","author":"Appalachian Regional Commission","year":"2021"},{"key":"2026071704522128400_hlag025-B4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1001\/jamanetworkopen.2024.8565","article-title":"Characteristics and health care utilization of patients with housing insecurity in the ED","volume":"7","author":"Ball","year":"2024","journal-title":"JAMA Network Open"},{"key":"2026071704522128400_hlag025-B5","doi-asserted-by":"publisher","first-page":"839","DOI":"10.1177\/00048674241259918","article-title":"Experiences of individuals presenting to the emergency department for mental health reasons: A systematic mixed studies review","volume":"58","author":"Bull","year":"2024","journal-title":"Australian & New Zealand Journal of Psychiatry"},{"key":"2026071704522128400_hlag025-B6","doi-asserted-by":"publisher","first-page":"758","DOI":"10.1080\/10826084.2024.2447430","article-title":"Social network barriers to extended-release naltrexone within rural Appalachia: Perspectives from justice-involved clients and clinicians","volume":"60","author":"Bunting","year":"2025","journal-title":"Substance Use & Misuse"},{"key":"2026071704522128400_hlag025-B7","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1093\/hsw\/hlae002","article-title":"Examining the role of self-harm in the relationship between emergency department service utilization and trauma-induced homelessness among homeless individuals in Texas","volume":"49","author":"Choudhury","year":"2024","journal-title":"Health & Social Work"},{"key":"2026071704522128400_hlag025-B8","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1080\/15332985.2025.2519399","article-title":"Recent daily life functioning among treatment-seeking adults in one Northern Appalachian mental health clinic: The role of social connectedness","volume":"24","author":"Clarkson-Hendrix","year":"2026","journal-title":"Social Work in Mental Health"},{"key":"2026071704522128400_hlag025-B9","doi-asserted-by":"publisher","first-page":"1086","DOI":"10.2105\/AJPH.2024.307744","article-title":"The war on drugs, racialized capitalism, and health care utilization among White people who use drugs in 22 rural Appalachian counties","volume":"114","author":"Cooper","year":"2024","journal-title":"American Journal of Public Health"},{"key":"2026071704522128400_hlag025-B10","doi-asserted-by":"publisher","first-page":"968","DOI":"10.1007\/s11524-024-00917-0","article-title":"Strategies to reduce frequent emergency department use among persons experiencing homelessness with mental health conditions: A scoping review","volume":"101","author":"Davis","year":"2024","journal-title":"Journal of Urban Health"},{"key":"2026071704522128400_hlag025-B11","first-page":"144","article-title":"Characteristics for low, high and very high emergency department use for mental health diagnoses from health records and structured interviews","volume":"25","author":"Fleury","year":"2024","journal-title":"Western Journal of Emergency Medicine"},{"key":"2026071704522128400_hlag025-B12","doi-asserted-by":"publisher","first-page":"864","DOI":"10.3390\/ijerph21070864","article-title":"Emergency department use among patients with mental health problems: Profiles, correlates, and outcomes","volume":"21","author":"Fleury","year":"2024","journal-title":"International Journal of Environmental Research and Public Health"},{"key":"2026071704522128400_hlag025-B13","doi-asserted-by":"publisher","DOI":"10.1111\/inm.13456","article-title":"Understanding why people experiencing a mental health crisis leave the emergency department before care: A qualitative interpretive study","volume":"34","author":"Innes","year":"2025","journal-title":"International Journal of Mental Health Nursing"},{"key":"2026071704522128400_hlag025-B14","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1080\/08897077.2021.1975869","article-title":"Social relationships, homelessness, and substance use among emergency department patients","volume":"43","author":"Jurewicz","year":"2022","journal-title":"Substance Abuse & Addiction Journal"},{"key":"2026071704522128400_hlag025-B15","doi-asserted-by":"publisher","first-page":"589","DOI":"10.1111\/acem.14442","article-title":"Patient views on emergency department screening and interventions related to housing","volume":"29","author":"Kelly","year":"2022","journal-title":"Academic Emergency Medicine"},{"key":"2026071704522128400_hlag025-B16","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1016\/j.jemermed.2019.08.005","article-title":"A narrative review of predictors of adult mental health emergency department return visits and interventions to reduce repeated use","volume":"57","author":"Kromka","year":"2019","journal-title":"Journal of Emergency Medicine"},{"key":"2026071704522128400_hlag025-B17","first-page":"1","article-title":"). Emergency department visits related to mental health disorders among adults, by race and Hispanic ethnicity: United States, 2018\u20132020","volume":"181","author":"Peters","year":"2023","journal-title":"National Health Statistics Reports"},{"key":"2026071704522128400_hlag025-B18","doi-asserted-by":"publisher","first-page":"894","DOI":"10.5811\/westjem.59054","article-title":"Emergency department use among recently homeless adults in a nationally representative sample","volume":"24","author":"Ryus","year":"2023","journal-title":"Western Journal of Emergency Medicine"},{"key":"2026071704522128400_hlag025-B19","doi-asserted-by":"publisher","first-page":"997","DOI":"10.1002\/jcop.23029","article-title":"Facilitating factors and barriers for use of medications to treat opioid use disorder (MOUD) among justice-involved individuals in rural Appalachia","volume":"52","author":"Staton","year":"2023","journal-title":"Journal of Community Psychology"},{"key":"2026071704522128400_hlag025-B20","author":"Substance Abuse and Mental Health Services Administration","year":"2021"},{"key":"2026071704522128400_hlag025-B21","doi-asserted-by":"publisher","DOI":"10.1001\/JAMANETWORKOPEN.2023.22720","article-title":"Patterns of US mental health\u2013related emergency department visits during the COVID-19 pandemic","volume":"6","author":"Villas-Boas","year":"2023","journal-title":"JAMA Network Open"}],"container-title":["Health &amp; Social Work"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/hsw\/article-pdf\/51\/3\/223\/68494861\/hlag025.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/hsw\/article-pdf\/51\/3\/223\/68494861\/hlag025.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T08:52:29Z","timestamp":1784278349000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/hsw\/article\/51\/3\/223\/8704476"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,9]]},"references-count":21,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,6,9]]},"published-print":{"date-parts":[[2026,8,1]]}},"URL":"https:\/\/doi.org\/10.1093\/hsw\/hlag025","relation":{},"ISSN":["0360-7283","1545-6854"],"issn-type":[{"value":"0360-7283","type":"print"},{"value":"1545-6854","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,8]]},"published":{"date-parts":[[2026,6,9]]}}}