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Felix S, Valery KM, Caiada M, Guionnet S, Bonilla-Guerrero J, Destaillats JM, Prouteau A. Personal recovery self-report outcome measures in serious mental illness: A systematic review of measurement properties. Clin Psychol Rev 2024; 112:102459. [PMID: 38943916 DOI: 10.1016/j.cpr.2024.102459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 04/26/2024] [Accepted: 06/10/2024] [Indexed: 07/01/2024]
Abstract
BACKGROUND Personal recovery represents a paradigm shift in mental healthcare. Validated self-report outcome measures (PROMs) are needed to facilitate the transformation towards recovery-oriented practices and services. Objectives were to identify published measures and analyze their measurement properties using a standardized methodology. METHODS Following the COSMIN guidelines, we conducted a systematic review of personal recovery PROMs in serious mental illness. The MEDLINE, PMC, PsycINFO, PsycARTICLES, PBSC and Scopus electronic databases were searched for articles published between May 2012 and February 2024. Full-text articles from a previous systematic review were also examined. RESULTS 91 studies were included in the review, describing 25 PROMs. Ten of them had not been identified in previous reviews. Quality of evidence was globally poor for most PROM measurement properties. Very little evidence was found for cross-cultural validity, measurement invariance, measurement error and criterion validity. The Recovery Assessment Scale and Questionnaire about the Process of Recovery showed the strongest evidence for sufficient psychometric data on a wide range of measurement properties. CONCLUSIONS Several personal recovery measures are now available. While research is still needed to enhance their validity on some psychometric properties, the current tools appear sufficient to cover most research and clinical needs.
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Affiliation(s)
- Simon Felix
- Psychology Laboratory (LabPsy) UR4139, Bordeaux University, 3 ter place de la Victoire, 33000 Bordeaux, France; ESPPAIR Unit, Department of Adult Psychiatry, Jonzac Hospital, 17500 Saint-Martial de Vitaterne, France.
| | - Kevin-Marc Valery
- Psychology Laboratory (LabPsy) UR4139, Bordeaux University, 3 ter place de la Victoire, 33000 Bordeaux, France
| | - Meryl Caiada
- Psychology Laboratory (LabPsy) UR4139, Bordeaux University, 3 ter place de la Victoire, 33000 Bordeaux, France
| | - Sarah Guionnet
- Psychology Laboratory (LabPsy) UR4139, Bordeaux University, 3 ter place de la Victoire, 33000 Bordeaux, France
| | - Julien Bonilla-Guerrero
- ESPPAIR Unit, Department of Adult Psychiatry, Jonzac Hospital, 17500 Saint-Martial de Vitaterne, France
| | - Jean-Marc Destaillats
- ESPPAIR Unit, Department of Adult Psychiatry, Jonzac Hospital, 17500 Saint-Martial de Vitaterne, France
| | - Antoinette Prouteau
- Psychology Laboratory (LabPsy) UR4139, Bordeaux University, 3 ter place de la Victoire, 33000 Bordeaux, France; ESPPAIR Unit, Department of Adult Psychiatry, Jonzac Hospital, 17500 Saint-Martial de Vitaterne, France
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Moeller SB, Larsen PV, Austin S, Slade M, Arendt IMTP, Andersen MS, Simonsen S. Scalability, test-retest reliability and validity of the Brief INSPIRE-O measure of personal recovery in psychiatric services. Front Psychiatry 2024; 15:1327020. [PMID: 38807686 PMCID: PMC11130469 DOI: 10.3389/fpsyt.2024.1327020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 04/29/2024] [Indexed: 05/30/2024] Open
Abstract
Introduction Mental health services have transitioned from treating symptoms to emphasizing personal recovery. Despite its importance, integrating personal recovery into clinical practice remains work in progress. This study evaluates the psychometric qualities of the Brief INSPIRE-O, a five-item patient-reported outcome measure assessing personal recovery. Method The study collected data from 2018 to 2020 at the Mental Health Services, Capital Region of Denmark, using an internet-based system examining 8,192 non-psychotic patients - receiving outpatient treatment. Materials This study evaluated the Brief INSPIRE-O and used measures of symptomatology (SCL-10), well-being (WHO-5), and social functioning (modified SDS). Results The study population comprised 76.8% females with a mean age of 32.9 years, and diagnoses included anxiety (28%), depression (34%), and personality disorder (19%). The mean Brief INSPIRE-O score (39.9) was lower than the general population norm (71.1). The Brief INSPIRE-O showed acceptable test-retest reliability (0.75), scalability (0.39), and internal consistency (0.73). Correlations with other mental health criteria were in the expected direction for symptomatology (-0.46), well-being (0.60), and social functioning (-0.43) and remained consistent across diagnoses. Discussion The Brief INSPIRE-O demonstrated strong psychometric qualities and could be recommended as a measure of personal recovery for use in both research and clinical practice. Its strong theoretical basis and short completion time make it suitable for use for research. Incorporating Brief INSPIRE-O into clinical assessment will further support the process of mental health systems re-orientating towards personal recovery.
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Affiliation(s)
- Stine Bjerrum Moeller
- Psychotherapeutic Center Stolpegård, Region Hovedstad Psychiatry, København, Denmark
- Department of Psychology, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- Department of Trauma and Torture Survivors, Mental Health Services of Southern Denmark, Vejle, Denmark
| | - Pia Veldt Larsen
- Mental Health Services in the Region of Southern Denmark, Vejle, Denmark
| | - Stephen Austin
- Department of Psychology, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- Psychiatric Research Unit, Psychiatry Region Zealand, Slagelse, Denmark
| | - Mike Slade
- Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
| | - Ida-Marie T. P. Arendt
- Department of Psychology, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- Department of Trauma and Torture Survivors, Mental Health Services of Southern Denmark, Vejle, Denmark
| | | | - Sebastian Simonsen
- Psychotherapeutic Center Stolpegård, Region Hovedstad Psychiatry, København, Denmark
- Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Copenhagen, Denmark
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Arendt IMTP, Gondan M, Juul S, Hastrup LH, Hjorthøj C, Bach B, Videbech P, Jørgensen MB, Moeller SB. Schema therapy versus treatment as usual for outpatients with difficult-to-treat depression: study protocol for a parallel group randomized clinical trial (DEPRE-ST). Trials 2024; 25:266. [PMID: 38627837 PMCID: PMC11022394 DOI: 10.1186/s13063-024-08079-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 03/28/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND About one third of patients with depression are in a condition that can be termed as "difficult-to-treat". Some evidence suggests that difficult-to-treat depression is associated with a higher frequency of childhood trauma and comorbid personality disorders or accentuated features. However, the condition is understudied, and the effects of psychotherapy for difficult-to-treat depression are currently uncertain. The aim of this trial is to investigate the beneficial and harmful effects of 30 sessions of individual schema therapy versus treatment as usual for difficult-to-treat depression in the Danish secondary, public mental health sector. METHODS In this randomized, multi-centre, parallel-group, superiority clinical trial, 129 outpatients with difficult-to-treat depression will be randomized (1:1) to 30 sessions of individual schema therapy or treatment as usual; in this context mainly group-based, short-term cognitive behaviour or psychodynamic therapy. The primary outcome is the change from baseline in depressive symptoms 12 months after randomization, measured on the observer-rated 6-item Hamilton Rating Scale for Depression. The secondary outcomes are health-related quality of life assessed with the European Quality of Life 5 Dimensions 5 Level Version, functional impairment assessed with the Work and Social Adjustment Scale, psychological wellbeing assessed with the WHO-5 Well-being Index, and negative effects of treatment assessed with the Negative Effects Questionnaire. Exploratory outcomes are improvement on patient self-defined outcomes, personal recovery, anxiety symptoms, anger reactions, metacognitive beliefs about anger, and perseverative negative thinking. Outcomes will be assessed at 6, 12, and 24 months after randomization; the 12-month time-point being the primary time-point of interest. Outcome assessors performing the depression-rating, data managers, statisticians, the data safety and monitoring committee, and conclusion makers for the outcome article will be blinded to treatment allocation and results. To assess cost-effectiveness of the intervention, a health economic analysis will be performed. DISCUSSION This trial will provide evidence on the beneficial and harmful effects, as well as the cost-effectiveness of schema therapy versus treatment as usual for outpatients with difficult-to-treat depression. The results can potentially improve treatment for a large and understudied patient group. TRIAL REGISTRATION ClinicalTrials.gov NCT05833087. Registered on 15th April 2023 (approved without prompts for revision on 27th April 2023).
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Affiliation(s)
- Ida-Marie T P Arendt
- Department of Psychology, University of Southern Denmark, Campusvej 55, 5230, Odense, Denmark.
- Department of Trauma- and Torture Survivors, Mental Health Services in the Region of Southern Denmark, Vestre Engvej 51, 7100, Vejle, Denmark.
| | - Matthias Gondan
- Department of Psychology, Universität Innsbruck, Innrain 52, 6020, Innsbruck, Austria
| | - Sophie Juul
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark
- Research Unit of Stolpegaard Psychotherapy Centre, Mental Health Services, Capital Region of Denmark, Stolpegaardsvej 20, 2820, Gentofte, Denmark
| | - Lene Halling Hastrup
- Psychiatric Research Unit, Psychiatry in Region Zealand, Faelledvej 6, 4200, Slagelse, Denmark
- Danish Centre for Health Economics (DaCHE), University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Carsten Hjorthøj
- Copenhagen Research Center for Mental Health - CORE, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
- Department of Public Health, Section of Epidemiology, University of Copenhagen, Øster Farimagsgade 5, 1353, Copenhagen K, Denmark
| | - Bo Bach
- Department of Psychology, University of Copenhagen, Øster Farimagsgade 2a, 1353, Copenhagen K, Denmark
- Center for Personality Disorder Research, Mental Health Services in Region Zealand, Fælledvej 6, 4Th Floor, 4200, Slagelse, Denmark
| | - Poul Videbech
- Centre for Neuropsychiatric Depression Research, Nordstjernevej 41, Mental Health Centre Glostrup, 2600, Glostrup, Denmark
| | - Martin Balslev Jørgensen
- Psychiatric Centre Copenhagen, Mental Health Services, Capital Region of Denmark, Frederiksberg Hospital, Hovedvejen 17, 2000, Frederiksberg, Denmark
- Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark
| | - Stine Bjerrum Moeller
- Department of Psychology, University of Southern Denmark, Campusvej 55, 5230, Odense, Denmark
- Department of Trauma- and Torture Survivors, Mental Health Services in the Region of Southern Denmark, Vestre Engvej 51, 7100, Vejle, Denmark
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Waks S, Morrisroe E, Reece J, Fossey E, Brophy L, Fletcher J. Consumers lived experiences and satisfaction with sub-acute mental health residential services. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02631-3. [PMID: 38456931 DOI: 10.1007/s00127-024-02631-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/31/2024] [Indexed: 03/09/2024]
Abstract
PURPOSE Sub-acute recovery-oriented facilities offer short-term residential support for people living with mental illness. They are generally highly regarded by consumers, with emerging evidence indicating that these services may support recovery. The aim of the current study was to explore the relationship between personal recovery and consumers' satisfaction with sub-acute residential services, and consumers' views about service features that aid recovery. METHODS Consumers at 19 adult Prevention and Recovery Care Services in Victoria, Australia, were invited to complete measures containing sociodemographic information and measures on personal recovery and wellbeing. After going home, participants were invited to complete measures on service satisfaction and experience. RESULTS Total and intrapersonal scores on the personal recovery measure increased significantly between Time 1 and Time 2, indicating marked improvement. Personal recovery and satisfaction measures were moderately to strongly correlated. Thematically analysed open-ended responses revealed themes of feeling connected, finding meaning and purpose, and self-empowerment as important aspects of these services, with some recommendations for improvements. CONCLUSION Sub-acute residential mental health care may support individuals' personal recovery; consumer satisfaction indicates these services also offer an acceptable and supportive environment for the provision of recovery-oriented care. Further exploring consumers' experiences of sub-acute residential services is essential to understand their effectiveness, opportunities for improvement and intended impacts on personal recovery.
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Affiliation(s)
- S Waks
- Discipline of Clinical Psychology, Graduate Schools of Health, University of Technology Sydney, Chippendale, NSW, Australia
| | - E Morrisroe
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - J Reece
- Discipline of Psychological Science, Australian College of Applied Professions, Melbourne, VIC, Australia
| | - E Fossey
- Department of Occupational Therapy, School of Primary and Allied Health Care, Monash University, Frankston, VIC, Australia
| | - L Brophy
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.
- The ALIVE National Centre for Mental Health Research Translation, The University of Melbourne, Melbourne, VIC, Australia.
- Social Work & Social Policy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, 3086, Australia.
| | - J Fletcher
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- The ALIVE National Centre for Mental Health Research Translation, The University of Melbourne, Melbourne, VIC, Australia
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Guala MM, Bikic A, Bul K, Clinton D, Mejdal A, Nielsen HN, Stenager E, Søgaard Nielsen A. "Maze Out": a study protocol for a randomised controlled trial using a mix methods approach exploring the potential and examining the effectiveness of a serious game in the treatment of eating disorders. J Eat Disord 2024; 12:35. [PMID: 38429839 PMCID: PMC10908122 DOI: 10.1186/s40337-024-00985-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 02/06/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Eating Disorders (ED) are severe and costly mental health disorders. The effects of existing treatment approaches are limited and there is a need to develop novel interventions, including digital strategies that can increase engagement and effectiveness. Maze Out is a new serious game coproduced by patients and ED therapists, which allows patients to "play" with the reality of an ED and reflect on associated challenges. OBJECTIVES The present study has two main objectives: (1) to evaluate the effectiveness of adding Maze Out to treatment as usual (TAU) in a randomised controlled trial (RCT); and (2) to examine in depth the potential of Maze Out by examining how it is perceived and used in the context of an RCT. METHODS Participants will be recruited from mental health care services, endocrinology departments or Community Centres offering treatment for ED. Patients suffering from ED (N = 94) will be randomised to either TAU or TAU plus Maze Out. Primary outcome will be measured in terms of changes in self-efficacy, measured by a 5-item self-efficacy questionnaire (5-item SE_ED). Secondary outcome measures will include feelings of ineffectiveness and self-image, as measured by Eating Disorder Inventory, version 3 (EDI-3), Brief INSPIRE-O and Structural Analysis of Social Behaviour Intrex Questionnaire (SAS-B). Data will be collected at baseline (enrolment in the study), and subsequently 8 and 15 weeks after inclusion. Experiences of playing Maze Out will be examined in a sub-sample of participants, utilising both quantitative user analytics and qualitative interview data of patients, interview data of significant others, and healthcare professionals to explore the possible impact of Maze Out on disorder insight, communication patterns between patients and therapists and understanding of their disorder. DISCUSSION To our knowledge Maze Out is the first serious game coproduced by patients and therapists. It is a novel and theoretically grounded intervention that may significantly contribute to the healing process of ED. If found effective, the potential for wide-spread impact and scalability is considerable. Trial registration ClinicalTrials.gov NCT05621018.
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Affiliation(s)
- Maria Mercedes Guala
- Psychiatric Research Unit, Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 18, 5000, Odense, Denmark.
| | - Aida Bikic
- Department of Regional Health Research, Faculty of Health, University of Southern Denmark, Odense, Denmark
- Child and Adolescent Psychiatric Services Southern Jutland, Region of Southern Denmark, Aabenraa, Denmark
| | - Kim Bul
- Centre for Intelligent Healthcare, Coventry University, Coventry, UK
| | - David Clinton
- Department of Medical Epidemiology and Biostatistics (MEB), Centre for Eating Disorders Innovation (CEDI), Karolinska Institute, Stockholm, Sweden
| | - Anna Mejdal
- Psychiatric Research Unit, Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 18, 5000, Odense, Denmark
- Open Patient Data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Helene Nygaard Nielsen
- Psychiatric Research Unit, Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 18, 5000, Odense, Denmark
| | - Elsebeth Stenager
- Department of Regional Health Research, Faculty of Health, University of Southern Denmark, Odense, Denmark
| | - Anette Søgaard Nielsen
- Psychiatric Research Unit, Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 18, 5000, Odense, Denmark
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Standal K, Solbakken OA, Rugkåsa J, Halvorsen MS, Abbass A, Wirsching C, Brakstad IE, Heiervang KS. Medication-Free Treatment in Mental Health Care How Does It Differ from Traditional Treatment? Patient Prefer Adherence 2024; 18:315-335. [PMID: 38327730 PMCID: PMC10849138 DOI: 10.2147/ppa.s435610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 12/18/2023] [Indexed: 02/09/2024] Open
Abstract
Background Norwegian authorities have implemented treatment units devoted to medication-free mental health treatment nationwide to improve people's freedom of choice. This article examines how medication-free treatment differs from treatment as usual across central dimensions. Methods The design was mixed methods including questionnaire data on patients from a medication-free unit and two comparison units (n 59 + 124), as well as interviews with patients (n 5) and staff (n 8) in the medication-free unit. Results Medication-free treatment involved less reliance on medications and more extensive psychosocial treatment that involved a culture of openness, expression of feelings, and focus on individual responsibility and intensive work. The overall extent of patient influence for medication-free treatment compared with standard treatment was not substantially different to standard treatment but varied on different themes. Patients in medication-free treatment had greater freedom to reduce or not use medication. Medication-free treatment was experienced as more demanding. For patients, this could be connected to a stronger sense of purpose and was experienced as helpful but could also be experienced as a type of pressure and lack of understanding. Patients in medication-free treatment reported greater satisfaction with the treatment, which may be linked to a richer psychosocial treatment package that focuses on patient participation and freedom from pressure to use medication. Conclusion The findings provide insights into how a medication-free treatment service might work and demonstrate its worth as a viable alternative for people who are not comfortable with the current medication focus of mental health care. Patients react differently to increased demands and clinicians should be reflexive of the dimensions of individualism-relationism in medication-free treatment services. This knowledge can be used to further develop and improve both medication-free treatment and standard treatment regarding shared decision-making. Trial Registration This study was registered with ClinicalTrials.gov (Identifier NCT03499080) on 17 April 2018.
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Affiliation(s)
- Kari Standal
- District Psychiatric Center Nedre Romerike, Akershus University Hospital, Lørenskog, Norway
| | | | - Jorun Rugkåsa
- Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
- Department of Mental Health, Oslo Metropolitan UniversityOslo, Norway
- Centre for Care Research, University of Southeastern Norway, Porsgrunn, Norway
| | | | - Allan Abbass
- Faculty of Medicine, Dalhousie University, Nova Scotia, Canada
| | | | | | - Kristin S Heiervang
- Research and Development Department, Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway
- Centre of Medical Ethics, Faculty of Medicine, University of Oslo, Oslo, Norway
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Kragh M, Dyrberg H, Speed M, Pedersen P, Kristiansen ST, Martiny K. The efficacy of a transdiagnostic sleep intervention for outpatients with sleep problems and depression, bipolar disorder, or attention deficit disorder: study protocol for a randomized controlled trial. Trials 2024; 25:57. [PMID: 38229181 DOI: 10.1186/s13063-024-07903-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 01/02/2024] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Patients with mental disorders have a higher prevalence of sleep problems than the general population. Sleep problems may include insomnia, circadian rhythm disorders, or hypersomnia. A transdiagnostic approach combining cognitive behavioral therapy for insomnia (CBT-I) with chronotherapy addressing a broad range of sleep problems has shown promising results in a limited number of studies. The aim of the study is to investigate the efficacy of a transdiagnostic sleep intervention for patients with sleep problems comorbid to bipolar disorder, unipolar depression, or attention deficit disorders. The primary hypothesis is that the intervention improves sleep quality compared with a control group. The secondary hypotheses are that the intervention increases subjective and objective sleep efficiency, reduces sleep onset latency, wake after sleep onset, number of awakenings, and severity of insomnia; and that it improves well-being, personal recovery, work ability, and consumption of sleep medication compared with a control group. METHODS The study is a randomized controlled trial enrolling 88 outpatients with bipolar disorder, major depression, or attention deficit disorder with symptoms of various sleep problems (insomnia, circadian rhythm disorders, or hypersomnia). Patients are allocated to either an intervention group receiving six sessions of transdiagnostic sleep treatment or to a control group receiving a single session of sleep hygiene education. Assessments are made at baseline, at week two, and after 6 weeks in both groups. Actigraphy is performed continuously throughout the 6-week study period for all patients. The primary outcome is changes in the subjective appraisal of sleep quality (Pittsburgh Sleep Quality Index). The secondary outcomes are changes in sleep efficiency, sleep onset latency, wake after sleep onset, number of nocturnal awakenings (based on actigraph and sleep diary data), changes in insomnia severity (Insomnia Severity Index), well-being (WHO-5 Well-Being Index), personal recovery (INSPIRE-O), work ability (Work Ability Index), and consumption of sleep medication (sleep-diaries). DISCUSSION The study was initiated in 2022 and the inclusion period will continue until mid-2024. The results may have implications for the development and implementation of additional treatment options for patients with mental disorders and comorbid sleep problems. TRIAL REGISTRATION ClinicalTrials.gov. NCT05406414. Registered on June 6, 2022.
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Affiliation(s)
- Mette Kragh
- Department of Affective Disorders, Aarhus University Hospital Psychiatry, Evald Krogs Gade 13A, 8000, Aarhus C, Denmark.
| | - Henny Dyrberg
- Department of Affective Disorders, Aarhus University Hospital Psychiatry, Evald Krogs Gade 13A, 8000, Aarhus C, Denmark
| | - Maria Speed
- Department of Affective Disorders, Aarhus University Hospital Psychiatry, Evald Krogs Gade 13A, 8000, Aarhus C, Denmark
| | - Pernille Pedersen
- DEFACTUM, Central Denmark Region, Evald Krogs Gade 16A, 8000, Aarhus C, Denmark
| | - Sanne Toft Kristiansen
- Research Unit for Nursing and Healthcare, Department of Public Health, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark
| | - Klaus Martiny
- Mental Health Centre Copenhagen, University Hospital Copenhagen, Hovedvejen 17, 2000, Frederiksberg, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Leamy M, Foye U, Hirrich A, Bjørgen D, Silver J, Simpson A, Ellis M, Johan-Johanson K. A systematic review of measures of the personal recovery orientation of mental health services and staff. Int J Ment Health Syst 2023; 17:33. [PMID: 37849003 PMCID: PMC10580616 DOI: 10.1186/s13033-023-00600-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 09/27/2023] [Indexed: 10/19/2023] Open
Abstract
PURPOSE This review aimed to update and extend the Williams and colleagues 2012 systematic review of measures of recovery-orientation of mental health services by examining whether any of the specific knowledge gaps identified in this original review had subsequently been addressed. METHODS A systematic review using CINAHL, ASSIA, Embase, PsycINFO, Medline and other sources, searched from 2012 until 2021. The conceptualisation of recovery and recovery-orientation of services was explored. Psychometric properties of measures were evaluated using quality criteria and according to ease of use. RESULTS Fourteen measures assessing aspects of the recovery orientation of services and staff were identified, of which ten met the eligibility. Psychometric properties were evaluated, and conceptualisations of recovery and recovery-orientation of services investigated. CONCLUSION After over a decade of research in the field of recovery outcome measurement, there remains a lack of a single gold-standard measure of recovery-orientation of mental health services. There is a need for researchers to develop a new gold standard measure of recovery-orientation of services that is psychometrically valid and reliable, demonstrates sensitivity to change and is easy to use. It needs to show a good fit to an underpinning conceptual model/ framework of both personal recovery and recovery-oriented services and/or systems, with different versions for stakeholders at each level of an organisation or system.
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Affiliation(s)
- Mary Leamy
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK.
| | - Una Foye
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Anne Hirrich
- KBT Competence Center for lived experience and service development, Trondheim, Norway
| | - Dagfin Bjørgen
- KBT Competence Center for lived experience and service development, Trondheim, Norway
| | | | - Alan Simpson
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Madeline Ellis
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Karl Johan-Johanson
- KBT Competence Center for lived experience and service development, Trondheim, Norway
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Aggestrup AS, Martiny F, Faurholt-Jepsen M, Hvenegaard M, Christensen R, Davidsen AS, Martiny K. Interventions promoting recovery from depression for patients transitioning from outpatient mental health services to primary care: Protocol for a scoping review. PLoS One 2023; 18:e0291559. [PMID: 37713450 PMCID: PMC10503712 DOI: 10.1371/journal.pone.0291559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 09/01/2023] [Indexed: 09/17/2023] Open
Abstract
INTRODUCTION Patients with severe Major Depressive Disorder (MDD) have an increasing risk of new psychiatric hospitalizations following each new episode of depression highlighting the recurrent nature of the disorder. Furthermore, patients are not fully recovered at the end of their treatment in outpatient mental health services, and residual symptoms of depression might explain why patients with MDD have a high risk of relapse. However, evidence of methods to promote recovery after discharge from outpatient mental health services is lacking. The proposed scoping review aims to systematically scope, map and identify the evidence and knowledge gaps on interventions that aims to promote recovery from MDD for patients transitioning from outpatient mental health services to primary care. MATERIALS AND METHODS The proposed scoping review will follow the latest methodological guidance by the Joanna Briggs Institute (JBI) in tandem with the Preferred Reporting Items for Systematic reviews and Meta-Analysis-extension for Scoping Reviews (PRISMA-ScR) checklist. The review is ongoing. Four electronic databases (Medline via PubMed, PsycINFO, CINAHL, and Sociological Abstracts) were systematically searched from 20 January 2022 till 29 March 2022 using keywords and text words. The review team consists of three independent screeners. Two screeners have completed the initial title and abstract screening for all studies retrieved by the search strategy. Currently, we are in the full text screening phase. Reference lists of included studies will be screened, and data will be independently extracted by the review team. Results will be analyzed qualitatively and quantitatively. DISCUSSION The chosen methodology is based on the use of publicly available information and does not require ethical approval. Results will be published in an international peer reviewed scientific journal, at national and international conferences and shared with relevant authorities. REGISTRATION A pre-print has been registered at the medRxiv preprint server for health sciences (doi.org/10.1101/2022.10.06.22280499).
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Affiliation(s)
- Anne Sofie Aggestrup
- Copenhagen Affective Disorder Research Centre (CADIC), New Interventions in Depression (NID) Group, Mental Health Centre Copenhagen, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Frederik Martiny
- The Research Unit for and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Center for Social Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Maria Faurholt-Jepsen
- Copenhagen Affective Disorder Research Centre (CADIC), Mental Health Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Morten Hvenegaard
- Competence Centre for Rehabilitation and Recovery, Mental Health Centre Ballerup, Ballerup, Denmark
| | - Robin Christensen
- Section for Biostatistics and Evidence-Based Research, The Parker Institute, Bispebjerg and Frederiksberg Hospital & Department of Clinical Research, University of Southern Denmark, Odense University Hospital, Denmark
| | - Annette Sofie Davidsen
- The Research Unit for and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Klaus Martiny
- Copenhagen Affective Disorder Research Centre (CADIC), New Interventions in Depression (NID) Group, Mental Health Centre Copenhagen, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Curth NK, Hjorthøj C, Brinck-Claussen U, Jørgensen KB, Rosendal S, Bojesen AB, Nordentoft M, Eplov LF. The effects of collaborative care versus consultation liaison for anxiety disorders and depression in Denmark: two randomised controlled trials. Br J Psychiatry 2023; 223:430-437. [PMID: 37395101 PMCID: PMC10895499 DOI: 10.1192/bjp.2023.77] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 03/23/2023] [Accepted: 05/09/2023] [Indexed: 07/04/2023]
Abstract
BACKGROUND Collaborative care (CC) and consultation liaison (CL) are two conceptual models aiming to improve mental healthcare in primary care. The effects of these models have not been compared in a Danish setting. AIMS To examine the effects of CC versus CL for persons with anxiety and depression in Danish general practices (trial registration: NCT03113175 and NCT03113201). METHOD Two randomised parallel superiority trials for anxiety disorders and depression were carried out in 2018-2019. In the CC-group, care managers collaborated with general practitioners (GPs) to provide evidence-based treatment according to structured treatment plans. They followed up and provided psychoeducation and/or cognitive-behavioural therapy. The GPs initiated pharmacological treatment if indicated, and a psychiatrist provided supervision. In the CL-group, the intervention consisted of the GP's usual treatment. However, the psychiatrist and care manager could be consulted. Primary outcomes were depression symptoms (Beck Depression Inventory-II, BDI-II) in the depression trial and anxiety symptoms (Beck Anxiety Inventory, BAI) in the anxiety trial at 6-month follow-up. RESULTS In total, 302 participants with anxiety disorders and 389 participants with depression were included. A significant difference in BDI-II score was found in the depression trial, with larger symptom reductions in the CC-group (CC: 12.7, 95% CI 11.4-14.0; CL: 17.5, 95% CI 16.2-18.9; Cohen's d = -0.50, P ≤ 0.001). There was a significant difference in BAI in the anxiety trial (CC: 14.9, 95% CI 13.5-16.3; CL: 17.9, 95% CI 16.5-19.3; Cohen's d = -0.34, P ≤ 0.001), with larger symptom reductions in the CC-group. CONCLUSIONS Collaborative care was an effective model to improve outcomes for persons with depression and anxiety disorders.
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Affiliation(s)
- Nadja Kehler Curth
- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen University Hospital, Mental Health Services - Capital Region of Denmark, Hellerup, Denmark
| | - Carsten Hjorthøj
- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen University Hospital, Mental Health Services - Capital Region of Denmark, Hellerup, Denmark; and Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
| | - Ursula Brinck-Claussen
- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen University Hospital, Mental Health Services - Capital Region of Denmark, Hellerup, Denmark
| | - Kirstine Bro Jørgensen
- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen University Hospital, Mental Health Services - Capital Region of Denmark, Hellerup, Denmark
| | - Susanne Rosendal
- Psychotherapeutic Clinic, Mental Health Center Copenhagen, Copenhagen University Hospital, Mental Health Services - Capital Region of Denmark, Copenhagen, Denmark
| | - Anders Bo Bojesen
- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen University Hospital, Mental Health Services - Capital Region of Denmark, Hellerup, Denmark
| | - Merete Nordentoft
- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen University Hospital, Mental Health Services - Capital Region of Denmark, Hellerup, Denmark; and Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lene Falgaard Eplov
- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Copenhagen University Hospital, Mental Health Services - Capital Region of Denmark, Hellerup, Denmark
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Thøgersen MH, Bager L, Bangsgaard SG, Palic S, Auning-Hansen M, Møller SB, Larsen KB, Tækker L, Jensen BS, Bothe S, Nordin L. The Danish Trauma Database for Refugees (DTD): A Multicenter Database Collaboration-Overcoming the Challenges and Enhancing Mental Health Treatment and Research for Refugees. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6611. [PMID: 37623194 PMCID: PMC10454926 DOI: 10.3390/ijerph20166611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 07/20/2023] [Accepted: 08/16/2023] [Indexed: 08/26/2023]
Abstract
Mental health of trauma-affected refugees is an understudied area, resulting in inadequate and poorer treatment outcomes. To address this, more high-quality treatment studies that include predictive analyses, long-term evaluations, cultural adaptations, and take account for comorbidities, are needed. Moreover, given the complex intertwining of refugees' health with post-migration stressors and other social factors, it is crucial to examine the social determinants of refugee mental health. The Danish Trauma Database for Refugees (DTD) is a multicenter research database uniting six national centers that provide outpatient treatment for trauma-affected refugees. Through the database, we collect clinical and sociodemographic data from approximately 1200 refugees annually and will merge the database with Danish population register data. The purpose of the DTD is two-fold; clinical and research. The DTD offers data-driven guidance for routine clinical treatment planning of the individual patient, as well as exceptional research opportunities for testing treatment interventions in clinical settings, with larger sample sizes, and more representative heterogeneity of the population. Complex analyses of risk and protective factors, barriers, access to treatment, and societal and transgenerational aspects of trauma are possible with the DTD. This conceptual paper introduces the DTD, the historical background, the development process and implementation strategy, and the associated challenges with developing and running a multicenter database. Most importantly, it highlights the clinical and research potential of the DTD for advancing the understanding and treatment of trauma-affected refugees.
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Affiliation(s)
- Marie Høgh Thøgersen
- The Danish Institute Against Torture (DIGNITY), 2100 Copenhagen, Denmark; (L.B.); (S.G.B.); (S.P.); (S.B.); (L.N.)
| | - Line Bager
- The Danish Institute Against Torture (DIGNITY), 2100 Copenhagen, Denmark; (L.B.); (S.G.B.); (S.P.); (S.B.); (L.N.)
- National Center for Register-Based Research, Aarhus University, 8210 Aarhus, Denmark
| | - Sofie Grimshave Bangsgaard
- The Danish Institute Against Torture (DIGNITY), 2100 Copenhagen, Denmark; (L.B.); (S.G.B.); (S.P.); (S.B.); (L.N.)
| | - Sabina Palic
- The Danish Institute Against Torture (DIGNITY), 2100 Copenhagen, Denmark; (L.B.); (S.G.B.); (S.P.); (S.B.); (L.N.)
| | | | - Stine Bjerrum Møller
- The Clinics for Trauma and Torture Survivors (ATT), 7100 Vejle, Denmark;
- Department of Psychology, University of Southern Denmark, 5230 Odense, Denmark
| | | | - Louise Tækker
- Privat Treatment Center for Traumatized Refugees and Their Families, (OASIS), 1164 Copenhagen, Denmark;
| | | | - Søren Bothe
- The Danish Institute Against Torture (DIGNITY), 2100 Copenhagen, Denmark; (L.B.); (S.G.B.); (S.P.); (S.B.); (L.N.)
| | - Linda Nordin
- The Danish Institute Against Torture (DIGNITY), 2100 Copenhagen, Denmark; (L.B.); (S.G.B.); (S.P.); (S.B.); (L.N.)
- Department of Psychology, Lund University, 22100 Lund, Sweden
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12
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Moeller SB, Gondan M, Austin SF, Slade M, Simonsen S. National norms of mental health for Denmark. Nord J Psychiatry 2023; 77:617-623. [PMID: 37129238 DOI: 10.1080/08039488.2023.2202637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 03/01/2023] [Accepted: 04/11/2023] [Indexed: 05/03/2023]
Abstract
INTRODUCTION To facilitate interpretation and clinical utility of patient-reported outcomes, normative data provide a reference for a person's score on a particular outcome in relation to the general population. This study reports Danish general population norms for four mental health indicators, assessing social functioning (Sheehan Disability Scale, SDS) personal recovery (Brief INSPIRE-O), symptom burden (Symptom Check List-10, SCL-10) and subjective well-being (WHO-5). METHODS The study was a cross-sectional survey study organized by the State's statistical authority among the general population of adult Danish residents in Denmark, ranging in age between 18 to 79 years. RESULTS A total of 8003 citizens were contacted including reminders from 2 March 2019 to 11 April 2019 by electronic letters, resulting in 2819 (35%) citizens providing complete responses. Female gender, higher age, Danish origin and living with a partner were associated with increased participation, and decreased participation was observed in male immigrants. We found a mean score of subjective well-being slightly lower than the population norm typically found in Danish general population studies. Elderly persons, Danes, and persons living with a partner reported better subjective mental health. Subjective well-being and personal recovery were positively correlated with social contacts and self-reported general health rating, and negatively correlated with social functioning and symptoms of depression and anxiety. CONCLUSION This normative data provides a reference for interpreting mental health status. Our findings indicate slightly poorer subjective mental health than previously found. There is a need for special attention to engaging male immigrants in studies on mental health in the general population.
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Affiliation(s)
- Stine Bjerrum Moeller
- Psychotherapy Research Unit, Mental Health Centre Stolpegaard, Capital Region Psychiatry, Denmark
- Southern Denmark Psychiatry, Department of Trauma and Torture survivors, Odense, Denmark
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | | | - Stephen F Austin
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- Psychiatric Research Unit, Psychiatry Region Zealand, Denmark
| | - Mike Slade
- School of Health Sciences, Institute of Mental Health, University of Nottingham, UK
- Nord University, Namsos, Norway
| | - Sebastian Simonsen
- Psychotherapy Research Unit, Mental Health Centre Stolpegaard, Capital Region Psychiatry, Denmark
- Department of Psychology, University of Copenhagen, Denmark
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Kido Y, Setoya N, Takasuna H, Kusachi H, Hirahara Y, Katayama S, Tachimori H, Funakoshi A, Kayama M. Service contents and recovery orientation of psychiatric home-visit nursing evaluated by users in Japan. Glob Health Med 2023; 5:136-141. [PMID: 37397949 PMCID: PMC10311670 DOI: 10.35772/ghm.2023.01041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/29/2023] [Accepted: 06/16/2023] [Indexed: 07/04/2023]
Abstract
The aim of this study was to clarify the differences perceived by users of home-visit nursing care between providers from medical institutions and services from independent home-visit nursing stations, as well as to examine the recovery orientation from the perspectives of the users. We conducted a questionnaire survey of 32 home-visit nursing stations and 18 medical institutions. From these facilities, 10 users of psychiatric home-visit nursing services who were being treated for schizophrenia and bipolar disorder were selected. With regard to the care that they thought was good, the home-visit nursing station users responded more often than users of home-visit nursing care provided by medical institutions regarding "help with hobbies and fun" and "support to empower you". Regarding what users wanted from home-visit nursing care, a statistically significant difference was found between users of home nursing stations who answered, "I want the same person to come", and users of home-visit nursing services provided by medical institutions, who answered, "I want various people to come". Brief INSPIRE-J score for study participants was 81.9 (standard deviation; SD 18.1) for users of home-visit nursing care services from medical institutions and 83.7 (SD 15.5) for home-visit nursing station users. It is conceivable that the care provided by psychiatric home-visit nursing services may have a greater potential for promoting recovery. However, since the characteristics of users and facilities may differ, future research is needed to clarify which recovery factors are effectively promoted by each service.
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Affiliation(s)
- Yoshifumi Kido
- Hamamatsu University School of Medicine, Shizuoka, Japan
| | | | - Hiroko Takasuna
- The National Association for Visiting Nurse Service, Tokyo, Japan
| | | | | | | | | | | | - Mami Kayama
- National College of Nursing, Japan, Tokyo, Japan
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Nielsen SS, Mikkelsen LJ, Quaade N, Gladstone TRG, Beardslee WR, Bonnemose K, Rosenberg NK, Hjorthøj C, Thorup AAE, Nordentoft M, Ranning A. A study protocol for the randomized controlled trial SAFIR FAMILY TALK: a selective primary preventive intervention vs. service as usual for children of parents with mental illness. Trials 2023; 24:291. [PMID: 37087437 PMCID: PMC10122450 DOI: 10.1186/s13063-023-07256-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 03/14/2023] [Indexed: 04/24/2023] Open
Abstract
BACKGROUND Children of parents with mental illness have an increased risk of developing mental illness themselves throughout their lifespan. This is due to genetic factors but also environmental disadvantages during childhood associated with parental mental illness. Selective primary preventive interventions for the children are recommended to mitigate risk factors and strengthen protective factors, but large-scale, longitudinal studies are needed. This study aims to investigate the effect of the Family Talk Preventive Intervention in a cohort of children and their parents with mental illness. METHODS The study is a randomized controlled trial with 286 planned families with at least one parent with any mental illness and at least one child aged 7 to 17 years. It will be carried out in the mental healthcare system in the Capital Region of Denmark. Families will be referred from hospitals and municipalities. The children and parents will be assessed at baseline and then randomized and allocated to either the Family Talk Preventive Intervention or service as usual. The intervention group will be assigned to Family Talk Preventive Intervention, a manualized programme consisting of ~ seven sessions for the family, including psychoeducation about parental mental illness and resilience in children, stimulating dialogue between family members and creating a common family narrative. The study period for both groups will be 12 months. Follow-up assessments will be conducted after 4 months and 12 months. The primary outcomes are the children's level of functioning, parental sense of competence and family functioning. DISCUSSION Given the prevalence of transgenerational transmission of mental illness, a systematic approach to prevention is needed in the mental healthcare setting. This study provides valuable knowledge on the Family Talk Preventive Intervention with a large sample size, inclusion of any parental mental illness and examination of the primary outcomes. TRIAL REGISTRATION ClinicalTrials.gov NCT05615324. Registered on 26 October 2022. Retrospectively registered.
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Affiliation(s)
- Signe S Nielsen
- Mental Health Center Copenhagen, Research Unit (CORE), Copenhagen, Capitol Region of Denmark, Denmark
| | - Lisbeth J Mikkelsen
- Mental Health Center Copenhagen, Research Unit (CORE), Copenhagen, Capitol Region of Denmark, Denmark
| | - Nikolaj Quaade
- Mental Health Center Copenhagen, Research Unit (CORE), Copenhagen, Capitol Region of Denmark, Denmark
| | | | | | - Katrina Bonnemose
- Mental Health Center Copenhagen, Research Unit (CORE), Copenhagen, Capitol Region of Denmark, Denmark
| | | | - Carsten Hjorthøj
- Mental Health Center Copenhagen, Research Unit (CORE), Copenhagen, Capitol Region of Denmark, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anne A E Thorup
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Child and Adolescent Mental Health Center, Copenhagen, Capital Region of Denmark, Denmark
| | - Merete Nordentoft
- Mental Health Center Copenhagen, Research Unit (CORE), Copenhagen, Capitol Region of Denmark, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anne Ranning
- Mental Health Center Copenhagen, Research Unit (CORE), Copenhagen, Capitol Region of Denmark, Denmark.
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
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Asher L, Rapiya B, Repper J, Reddy T, Myers B, Hanlon C, Petersen I, Brooke-Sumner C. Peer-led recovery groups for people with psychosis in South Africa (PRIZE): protocol for a randomised controlled feasibility trial. Pilot Feasibility Stud 2023; 9:19. [PMID: 36726164 PMCID: PMC9890934 DOI: 10.1186/s40814-022-01232-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 12/16/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND The available care for people with psychosis in South Africa is inadequate to support personal recovery. Group peer support interventions are a promising approach to foster recovery, but little is known about the preferences of service users, or the practical application of this care model, in low- and middle-income countries (LMIC). This study aims to assess the acceptability and feasibility of integrating peer-led recovery groups for people with psychosis and their caregivers in South Africa into existing systems of care, and to determine key parameters in preparation for a definitive trial. METHODS The study is set in Nelson Mandela Bay Metropolitan district of the Eastern Cape Province, South Africa. The design is an individually randomised parallel group feasibility trial comparing recovery groups in addition to treatment as usual (TAU) with TAU alone in a 1:1 allocation ratio. We aim to recruit 100 isiXhosa-speaking people with psychosis and 100 linked caregivers. TAU comprises anti-psychotic medication-focused outpatient care. The intervention arm will comprise seven recovery groups, including service users and caregiver participants. Recovery groups will be delivered in two phases: a 2-month phase facilitated by an auxiliary social worker, then a 3-month peer-led phase. We will use mixed methods to evaluate the process and outcomes of the study. Intervention acceptability and feasibility (primary outcomes) will be assessed at 5 months post-intervention start using qualitative data collected from service users, caregivers, and auxiliary social workers, along with quantitative process indicators. Facilitator competence will be assessed with the GroupACT observational rating tool. Trial procedures will be assessed, including recruitment and retention rates, contamination, and validity of quantitative outcome measures. To explore potential effectiveness, quantitative outcome data (functioning, unmet needs, personal recovery, internalised stigma, health service use, medication adherence, and caregiver burden) will be collected at baseline, 2 months, and 5 months post-intervention start. DISCUSSION This study will contribute to the sparse evidence on the acceptability and feasibility of peer-led and recovery-oriented interventions for people with psychosis in LMIC when integrated into existing care systems. Results from this feasibility trial will inform preparations for a definitive trial and subsequent larger-scale implementation. TRIAL REGISTRATION Pan-African Clinical Trials Register PACTR202202482587686. Registered on 28 February 2022. https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=21496 .
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Affiliation(s)
- Laura Asher
- Academic Unit of Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK.
| | - Bongwekazi Rapiya
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Francie Van Zijl Drive, Parow Valley, Cape Town, 7501, South Africa
| | - Julie Repper
- Implementing Recovery through Organisational Change, Nottingham, UK
| | - Tarylee Reddy
- Biostatistics Research Unit, South African Medical Research Council, Durban, South Africa
| | - Bronwyn Myers
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Francie Van Zijl Drive, Parow Valley, Cape Town, 7501, South Africa.,Curtin enAble Institute, Curtin University, Perth, Western Australia, 6151, Australia.,Department of Psychiatry and Mental Health, University of Cape Town, J-Block, Groote Schuur Hospital, Observatory, Cape Town, South Africa
| | - Charlotte Hanlon
- Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Department of Psychiatry, College of Health Sciences, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Inge Petersen
- Centre for Rural Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Carrie Brooke-Sumner
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Francie Van Zijl Drive, Parow Valley, Cape Town, 7501, South Africa
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Social Factors and Recovery: A Longitudinal Study of Patients with Psychosis in Mental Health Services. Community Ment Health J 2023; 59:294-305. [PMID: 35976477 PMCID: PMC9859912 DOI: 10.1007/s10597-022-01007-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 07/01/2022] [Indexed: 01/25/2023]
Abstract
To study the prospective associations between social factors and recovery in patients with psychotic disorders in mental health specialist services. In this prospective observational cohort study, analyzes were based on baseline- and follow-up data after 18 months from 108 patients with psychosis. Personal recovery was assessed by the Questionnaire about the Process of Recovery (QPR). Linear regression models were used to test the prospective associations between social predictor variables and QPR. An association was found between experienced quality of interpersonal relationships at baseline and change in QPR score over the next 18 months. Stratified analyzes showed that the effect of experienced quality of interpersonal relationships on recovery was due to an association among persons living with others. Patients' experience of quality of interpersonal relationships are prospectively associated with recovery. In conclusion, findings indicate that interpersonal relationships and social interaction are central drivers of recovery in patients with psychotic disorders.
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Lin E, Harris H, Black G, Bellissimo G, Di Giandomenico A, Rodak T, Costa-Dookhan KA, Shier R, Rovet J, Gruszecki S, Soklaridis S. Evaluating recovery colleges: a co-created scoping review. J Ment Health 2022:1-22. [PMID: 36345859 DOI: 10.1080/09638237.2022.2140788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Recovery Colleges (RCs) are education-based centres providing information, networking, and skills development for managing mental health, well-being, and daily living. A central principle is co-creation involving people with lived experience of mental health/illness and/or addictions (MHA). Identified gaps are RCs evaluations and information about whether such evaluations are co-created. AIMS We describe a co-created scoping review of how RCs are evaluated in the published and grey literature. Also assessed were: the frameworks, designs, and analyses used; the themes/outcomes reported; the trustworthiness of the evidence; and whether the evaluations are co-created. METHODS We followed Arksey and O'Malley's methodology with one important modification: "Consultation" was re-conceptualised as "co-creator engagement" and was the first, foundational step rather than the last, optional one. RESULTS Seventy-nine percent of the 43 included evaluations were peer-reviewed, 21% grey literature. These evaluations represented 33 RCs located in the UK (58%), Australia (15%), Canada (9%), Ireland (9%), the USA (6%), and Italy (3%). CONCLUSION Our findings depict a developing field that is exploring a mix of evaluative approaches. However, few evaluations appeared to be co-created. Although most studies referenced co-design/co-production, few described how much or how meaningfully people with lived experience were involved in the evaluation.
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Affiliation(s)
- Elizabeth Lin
- Department of Education, Centre for Addiction and Mental Health, Toronto, Canada
| | - Holly Harris
- Ontario Shores Centre for Mental Health Sciences, Whitby, Canada
| | - Georgia Black
- Department of Education, Centre for Addiction and Mental Health, Toronto, Canada
| | - Gail Bellissimo
- Department of Education, Centre for Addiction and Mental Health, Toronto, Canada
| | | | - Terri Rodak
- Department of Education, Centre for Addiction and Mental Health, Toronto, Canada
| | | | - Rowen Shier
- Department of Education, Centre for Addiction and Mental Health, Toronto, Canada
| | - Jordana Rovet
- Department of Education, Centre for Addiction and Mental Health, Toronto, Canada
| | - Sam Gruszecki
- Department of Education, Centre for Addiction and Mental Health, Toronto, Canada
| | - Sophie Soklaridis
- Department of Education, Centre for Addiction and Mental Health, Toronto, Canada
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Recovery Colleges Characterisation and Testing in England (RECOLLECT): rationale and protocol. BMC Psychiatry 2022; 22:627. [PMID: 36153488 PMCID: PMC9509550 DOI: 10.1186/s12888-022-04253-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 09/11/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Recovery Colleges are a relatively recent initiative within mental health services. The first opened in 2009 in London and since then numbers have grown. They are based on principles of personal recovery in mental health, co-production between people with lived experience of mental health problems and professionals, and adult learning. Student eligibility criteria vary, but all serve people who use mental health services, with empirical evidence of benefit. Previously we developed a Recovery College fidelity measure and a preliminary change model identifying the mechanisms of action and outcomes for this group, which we refer to as service user students. The Recovery Colleges Characterisation and Testing (RECOLLECT) study is a five-year (2020-2025) programme of research in England. The aim of RECOLLECT is to determine Recovery Colleges' effectiveness and cost-effectiveness, and identify organisational influences on fidelity and improvements in mental health outcomes. METHODS: RECOLLECT comprises i) a national survey of Recovery Colleges, ii) a prospective cohort study to establish the relationship between fidelity, mechanisms of action and psychosocial outcomes, iii) a prospective cohort study to investigate effectiveness and cost-effectiveness, iv) a retrospective cohort study to determine the relationship between Recovery College use and outcomes and mental health service use, and v) organisational case studies to establish the contextual and organisational factors influencing fidelity and outcomes. The programme has been developed with input from individuals who have lived experience of mental health problems. A Lived Experience Advisory Panel will provide input into all stages of the research. DISCUSSION RECOLLECT will provide the first rigorous evidence on the effectiveness and cost effectiveness of Recovery Colleges in England, to inform their prioritising, commissioning, and running. The validated RECOLLECT multilevel change model will confirm the active components of Recovery Colleges. The fidelity measure and evidence about the fidelity-outcome relationship will provide an empirically-based approach to develop Recovery Colleges, to maximise benefits for students. Findings will be disseminated through the study website (researchintorecovery.com/recollect) and via national and international Recovery College networks to maximise impact, and will shape policy on how Recovery Colleges can help those with mental health problems lead empowered, meaningful and fulfilling lives.
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Reinke B, Mahlke C, Botros C, Kläring A, Lambert M, Karow A, Gallinat J, Zapf A, Ozga AK, Höller A, Bustami N, Reimer J, Lüdtke J, Schaper O, Lison M, Bechdolf A, Baumgardt J, Spiegel J, Hardt O, Rout S, Memarzadeh S, von Peter S, Schwarz J, Langer C, Glotz S, Frasch K, Rüsch N, Künstler U, Bock T, Becker T. Study protocol of a randomized controlled trial evaluating home treatment with peer support for acute mental health crises (HoPe). BMC Psychiatry 2022; 22:619. [PMID: 36123649 PMCID: PMC9483879 DOI: 10.1186/s12888-022-04247-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 09/07/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Home treatment (HT) is a treatment modality for patients with severe mental illness (SMI) in acute mental crises. It is frequently considered equivalent to psychiatric inpatient treatment in terms of treatment outcome. Peer Support (PS) means that people with lived experience of a mental illness are trained to support others on their way towards recovery. While PS is growing in international importance and despite a growing number of studies supporting its benefits, it is still not comprehensively implemented into routine care. The HoPe (Home Treatment with Peer Support) study investigates a combination of both - HT and PS - to provide further evidence for a recovery-oriented treatment of psychiatric patients. METHODS In our randomized controlled trial (RCT), HT with PS is compared with HT without PS within a network of eight psychiatric clinical centers from the North, South and East of Germany. We investigate the effects of a combination of both approaches with respect to the prevention of relapse/recurrence defined as first hospitalization after randomization (primary outcome), disease severity, general functioning, self-efficacy, psychosocial health, stigma resistance, recovery support, and service satisfaction (secondary outcomes). A sample of 286 patients will be assessed at baseline after admission to HT care (data point t0) and randomized into the intervention (HT + PS) and control arm (HT). Follow-Up assessments will be conducted 2, 6 and 12 months after admission (resulting in three further data points, t1 to t3) and will be analyzed via intention-to-treat approach. DISCUSSION This study may determine the positive effects of PS added to HT, prove additional evidence for the efficacy of PS and thereby facilitate its further implementation into psychiatric settings. The aim is to improve quality of mental health care and patients' recovery as well as to reduce the risk of relapses and hospitalizations for patients with SMI. TRIAL REGISTRATION The trial is registered with ClinicalTrials.gov: NCT04336527 , April 7, 2020.
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Affiliation(s)
- Britta Reinke
- grid.13648.380000 0001 2180 3484Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Candelaria Mahlke
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Christina Botros
- grid.13648.380000 0001 2180 3484Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alexa Kläring
- grid.13648.380000 0001 2180 3484Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Lambert
- grid.13648.380000 0001 2180 3484Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anne Karow
- grid.13648.380000 0001 2180 3484Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jürgen Gallinat
- grid.13648.380000 0001 2180 3484Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Antonia Zapf
- grid.13648.380000 0001 2180 3484Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ann-Kathrin Ozga
- grid.13648.380000 0001 2180 3484Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alexandra Höller
- grid.13648.380000 0001 2180 3484Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Nadia Bustami
- Department of Psychiatry and Psychotherapy, Psychiatric Hospital Lüneburg, Lüneburg, Germany
| | - Jens Reimer
- grid.13648.380000 0001 2180 3484Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany ,Department of Psychiatry and Psychotherapy, Gesundheit Nord - Bremen Hospital Group, Bremen, Germany
| | - Jenny Lüdtke
- Department of Psychiatry and Psychotherapy, Gesundheit Nord - Bremen Hospital Group, Bremen, Germany
| | - Oliver Schaper
- Department of Psychiatry and Psychotherapy, Gesundheit Nord - Bremen Hospital Group, Bremen, Germany
| | - Martin Lison
- Department of Psychiatry and Psychotherapy, Gesundheit Nord - Bremen Hospital Group, Bremen, Germany
| | - Andreas Bechdolf
- grid.6363.00000 0001 2218 4662Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Vivantes Hospital Am Urban Und Vivantes Hospital Im Friedrichshain, Charité – Universitätsmedizin Berlin, Berlin, Germany ,grid.415085.dDepartment of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Friedrichshain Hospital, Berlin, Germany ,grid.411097.a0000 0000 8852 305XDepartment of Psychiatry and Psychotherapy, University Hospital Cologne, Cologne, Germany
| | - Johanna Baumgardt
- grid.6363.00000 0001 2218 4662Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Vivantes Hospital Am Urban Und Vivantes Hospital Im Friedrichshain, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Jennifer Spiegel
- grid.6363.00000 0001 2218 4662Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Vivantes Hospital Am Urban Und Vivantes Hospital Im Friedrichshain, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Olaf Hardt
- Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Neukölln Hospital, Berlin, Germany
| | - Sandeep Rout
- Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Neukölln Hospital, Berlin, Germany
| | - Sonja Memarzadeh
- Department of Psychiatry, Psychotherapy and Psychosomatics, Vivantes Neukölln Hospital, Berlin, Germany
| | - Sebastian von Peter
- grid.473452.3Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Immanuel Clinic Rüdersdorf, Rüdersdorf, Germany
| | - Julian Schwarz
- grid.473452.3Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Immanuel Clinic Rüdersdorf, Rüdersdorf, Germany
| | - Claudia Langer
- grid.473452.3Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Immanuel Clinic Rüdersdorf, Rüdersdorf, Germany
| | - Sabine Glotz
- grid.6582.90000 0004 1936 9748Department of Psychiatry II, Ulm University, Günzburg Regional Hospital, Günzburg, Germany
| | - Karel Frasch
- grid.6582.90000 0004 1936 9748Department of Psychiatry II, Ulm University, Günzburg Regional Hospital, Günzburg, Germany ,Donauwörth Regional Hospital, Donauwörth, Germany
| | - Nicolas Rüsch
- grid.6582.90000 0004 1936 9748Department of Psychiatry II, Ulm University, Günzburg Regional Hospital, Günzburg, Germany
| | - Ulf Künstler
- Department of Psychiatry and Psychotherapy, Asklepios Western Hospital Hamburg, Rissen, Germany
| | - Thomas Bock
- grid.13648.380000 0001 2180 3484Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Thomas Becker
- grid.6582.90000 0004 1936 9748Department of Psychiatry II, Ulm University, Günzburg Regional Hospital, Günzburg, Germany
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Jørgensen K, Hansen M, Karlsson B. Recovery-Oriented Practices in a Mental Health Centre for Citizens Experiencing Serious Mental Issues and Substance Use: As Perceived by Healthcare Professionals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10294. [PMID: 36011927 PMCID: PMC9408666 DOI: 10.3390/ijerph191610294] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/15/2022] [Accepted: 08/16/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Recovery-oriented practices have become a means of promoting user recovery during hospitalisation, but we do not know much about the concrete means of practicing recovery-orientation for the most vulnerable users with serious mental difficulty and substance use. AIMS We investigated the concrete means of practicing recovery-orientation in care work and the elements, dimensions, outcomes, or steps of it in a special department of mental health centres. METHOD Focus group interviews were conducted with 16 health professionals with experience with users with serious mental difficulty and substance use. Qualitative content analysis was undertaken. RESULTS The main theme was "holistic recovery on structural terms" based on two themes and four subthemes. The first theme was "recovery based on an individual approach" with subthemes "detective-find hope" and "how to do recovery-oriented practice". The next theme was "recovery subject to structural framework" with subthemes "tension between different interests" and "symptoms as a barrier". CONCLUSIONS recovery-oriented practice is understood as an approach where health professionals emphasise forming relationships based on trust, being hopeful for the users' future, spending time with users, and respecting users' experiences and knowledge from their own life. There are cross-pressures between different interests. The desire to meet the users' perspectives and respect these perspectives but at the same time live up to mental health centre purposes to stabilise the users' health and achieve self-care.
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Affiliation(s)
- Kim Jørgensen
- Science in Nursing Department of Public Health, Bartholins Allé 2, 8000 Aarhus, Denmark
| | - Morten Hansen
- Psychiatric Outpatient Clinic Ishøj, Bostedsteamet, Store Torv 20, 2635 Ishøj, Denmark
| | - Bengt Karlsson
- Center for Mental Health and Substance Abuse, Department of Health, Social and Welfare Studies, Faculty of Health and Social Sciences, University of Southeastern Norway, Postbox 7053, 3007 Drammen, Norway
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21
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Effectiveness of personal recovery facilitators in adults with schizophrenia and other psychoses: A systematic review of reviews and narrative synthesis. Schizophr Res 2022; 246:132-147. [PMID: 35777151 DOI: 10.1016/j.schres.2022.06.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 06/14/2022] [Accepted: 06/19/2022] [Indexed: 01/12/2023]
Abstract
This review aimed to examine the evidence base for the use of personal recovery facilitators [non-psychopharmacological approaches] for adults with a diagnosis of schizophrenia and other psychoses. A systematic review (umbrella review) was conducted of reviews published in English between January 2010 and February 2022, which examined the effectiveness of personal recovery facilitators to support aspects of personal recovery as defined by the CHIME framework (connectedness, hope and optimism, identity, meaning and purpose, and empowerment). Twenty-one systematic reviews on thirteen different types of personal recovery facilitators [PRFs] were included in this umbrella review. Only one review sought to directly measure personal recovery processes according to the CHIME framework. Outcome measures mostly aligned with the processes of hope (21 reviews) and connectedness (19 reviews). Those related to empowerment (2 reviews), identity (5 reviews) and meaning and purpose (1 review) were less frequently the focus of PRFs. Yoga and music therapy showed the most promise as PRFs. Vocational treatments and integrated supported employment show good potential as personal recovery facilitators. However, together with narrative photovoice, art making and exhibition, they require further robust research to fully examine their impact. Personal recovery is only beginning to be considered as an intended outcome of interventions for persons with schizophrenia and other psychoses. This may be due in part to the continued predominance of the biomedical model approach to recovery within statutory services. Future evaluations of PRFs should include outcome measures that directly assess personal recovery according to the CHIME framework or other measures developed in consultation with recipients of these approaches. Review registration number and date: PROSPERO 2020 CRD42020215471: 10/11/20.
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22
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Eklund M, Tjörnstrand C. Resident and staff perceptions of an activity- and recovery-based intervention in supported housing for people with severe mental illness - a longitudinal pilot study. BMC Psychiatry 2022; 22:404. [PMID: 35710347 PMCID: PMC9205036 DOI: 10.1186/s12888-022-04050-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 06/07/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND People with severe mental illness who reside in supported housing (SH) and need a high level of assistance are at risk of an everyday life with little meaning and low community participation. Interventions to counteract that seem warranted, which was the rationale for this study. The aim was to investigate how residents and staff perceived an intervention designed to enhance meaningful everyday activity and personal recovery. METHODS The intervention, termed Active in My Home (AiMH), was led by an occupational therapist. It consisted of five individual and three group sessions, and AiMH staff acted as supporters. Twenty-nine AiMH participants and 43 staff members were included in this un-controlled study with three measurement points - before (T1), at completion (T2), and 6-9 months after completion of AiMH (T3). The data collection was based on self-report questionnaires addressing perceptions of satisfaction, meaningfulness, and recovery-oriented support. RESULTS The residents' satisfaction with the SH per se was rated high (at 75% of the maximum score) and did not change over the study period from T1 to T3 (p = 0.544); nor did the participants' perceived recovery-oriented support from the AiMH supporter (p = 0.235). Satisfaction with AiMH was rated by both participants and staff at T2. Their scores differed regarding general satisfaction (p = 0.008), staff scoring higher, but no differences were found regarding satisfaction with group sessions, individual sessions, or support of activity (p-values 0.062-0.836). The staff rated the SH unit's provision of meaningful activities higher than the AIMH participants at T2 (p = 0.029) but not at T1 (p = 0.226) or T3 (p = 0.499). CONCLUSION This study has offered some glimpses of how AiMH participants and staff perceived the AiMH intervention. It has also generated some ideas for better support for meaningful activity and recovery-oriented support in SH for people with mental illness, such as assisting SH residents in identifying activity opportunities and making activity choices when providing support for meaningful activity in the SH context. TRIAL REGISTRATION Registered at ClinicalTrials.gov ID: NCT05157854.
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Affiliation(s)
- Mona Eklund
- Department of Health Sciences, Lund University, P. O. Box 157, SE-22100, Lund, Sweden.
| | - Carina Tjörnstrand
- grid.4514.40000 0001 0930 2361Department of Health Sciences, Lund University, P. O. Box 157, SE-22100 Lund, Sweden
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23
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Segeren M, Lauriks S, Kikkert M, Heering J, Lommerse N, van Husen G, Verhoeff A. Deinstitutionalization from the perspective of community-dwelling adults with a severe mental illness in Amsterdam: a cohort study protocol. BMC Public Health 2022; 22:950. [PMID: 35549681 PMCID: PMC9097409 DOI: 10.1186/s12889-022-13291-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 04/25/2022] [Indexed: 11/10/2022] Open
Abstract
Background People with a severe mental illness (SMI) increasingly receive ambulatory forms of care and support. The trend of deinstitutionalization accelerated in the Netherlands from 2008 and onwards without sufficient understanding of its consequences. The study protocol herein focuses on deinstitutionalization from the perspective of adults with an SMI living within the community in Amsterdam and aims at delivering better insight into, amongst others, their recovery, quality of life, societal participation and needs for care and support. Methods A cohort design will be used. A representative sample of community-dwelling adults with an SMI, including those in care (n = 650) and not in care (n = 150), will be followed over time. During a two-year time period, participants will be interviewed twice using a wide-ranging set of validated instruments. Interview data will be matched with administrative data about the care process, as retrieved from their patient files. Primary outcomes are changes over time in recovery, societal participation and quality of life, controlled for the occurrence of adverse life-events during follow-up. Additionally, prevalence estimates of and associations between social functioning, safety and discrimination, substance use and health indicators will be investigated. Discussion The study protocol aims at delivering a comprehensive insight into the needs of community-dwelling adults with an SMI based on which ambulatory care and support can best be provided to optimally promote their social recovery and well-being.
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Affiliation(s)
- Menno Segeren
- Public Health Service Amsterdam, Department of Epidemiology, Health Promotion and Care Innovation, Amsterdam, the Netherlands.
| | - Steve Lauriks
- Public Health Service Amsterdam, Department of Epidemiology, Health Promotion and Care Innovation, Amsterdam, the Netherlands
| | - Martijn Kikkert
- Department of Research, Arkin Mental Health Care Institute, Amsterdam, the Netherlands
| | - Jet Heering
- GGZ inGeest, Department of Research & Innovation, Amsterdam, the Netherlands
| | - Nick Lommerse
- Department of Research, Arkin Mental Health Care Institute, Amsterdam, the Netherlands
| | - Gwen van Husen
- Public Health Service Amsterdam, Department of Epidemiology, Health Promotion and Care Innovation, Amsterdam, the Netherlands
| | - Arnoud Verhoeff
- Public Health Service Amsterdam, Department of Epidemiology, Health Promotion and Care Innovation, Amsterdam, the Netherlands.,Department of Sociology, University of Amsterdam, Amsterdam, the Netherlands
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24
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Jørgensen K, Andreasson K, Rasmussen T, Hansen M, Karlsson B. Recovery-Oriented Cross-Sectoral Network Meetings between Mental Health Hospital Professionals and Community Mental Health Professionals: A Critical Discourse Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063217. [PMID: 35328905 PMCID: PMC8956063 DOI: 10.3390/ijerph19063217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 03/03/2022] [Accepted: 03/04/2022] [Indexed: 11/16/2022]
Abstract
Aims and objectives: In the medical field, we lack knowledge on how interprofessional collaboration across sectors is carried out. This paper explores how healthcare professionals and users perceive recovery-oriented cross-sectoral discharge network meetings between mental health hospital professionals and community mental health professionals and which discourses manifest themselves within the field of mental healthcare. Method: Ten professionals from a mental health hospital and eight community mental health professionals participated. In addition, five users with experience in mental health services in both sectors participated. Fairclough’s discourse analysis framework was used to explore their experiences. The study was designed following the ethical principles of the Helsinki Declaration and Danish law. Each study participant in the two intersectoral sectors gave their informed consent after verbal and written information was provided. The Consolidated Criteria for Reporting Qualitative Research checklist was used as a guideline to secure accurate and complete reporting of the study). Results: The healthcare professionals in both sectors are governed by steering tools, legislation and a strong biomedical tradition to solve illness-related problems, such that users must be offered treatment and support to achieve self-care as soon as possible. This can be seen as a reflection of, and a driving force in, a change in the wider social practice that Fairclough terms the ‘marketisation of discourse’—a social development in late modernity, whereby market discourse colonises the discursive practices of public institutions. The user of psychiatric and social services experiences a structured system that does not offer the necessary time for deep conversations. Users do not consider recovery as something that is only seen in relation to the efforts of the professionals, as recovery largely takes place independently of professionals. Recovery depends on users’ internal resources and a strong network that can support them on the journey. Conclusion: Healthcare professionals perceive recovery-oriented cross-sectoral discharge network meetings to reflect paternalistic and biomedical discourses. Users want to be seen more as whole persons and did not experience sufficient involvement in the intersectoral care. Relevance to clinical practice: Healthcare professionals need to be supported to seek clarity in the understanding and operationalisation of a recovery-oriented approach, if the agenda is to be truly adopted and strengthened.
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Affiliation(s)
- Kim Jørgensen
- Department of Public Health, Nursing and Health Care, Aarhus University, 8000 Aarhus, Denmark
- Psychiatric Centre North Zealand, 3400 Hillerød, Denmark;
- Correspondence:
| | | | - Tonie Rasmussen
- Department of Social and Health, Center for Quality and Development, 3460 Birkerød, Denmark;
| | - Morten Hansen
- Psychiatric Outpatient Clinic, Residence Team, 2635 Ishøj, Denmark;
| | - Bengt Karlsson
- Center of Mental Health and Substance Abuse, Department of Health-, Social- and Welfare Studies, Faculty of Health and Social Sciences, University og Southeastern Norway, 3007 Drammen, Norway;
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25
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Jørgensen K, Rasmussen T, Hansen M, Andreasson K, Karlsson B. Recovery-Oriented Network Meetings in Mental Healthcare: A Qualitative Study. Issues Ment Health Nurs 2022; 43:164-171. [PMID: 34469284 DOI: 10.1080/01612840.2021.1961178] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Recovery-oriented cross-sectoral collaboration is a cornerstone of the debate concerning health professionals and users of mental health services and constitutes an objective in government health policy in Scandinavia and other Western countries. Users do not find that professionals communicate with each other across specific sectors regarding plans that have been prepared. They often experience that they have to start over again every time they switch between treatment locations. The aim of this study is to develop a recovery-oriented model for network meetings. Health professionals and users with experience from mental health services participated in three workshops to discuss and achieve a plan for recovery-oriented network meetings. Knowledge was generated in dynamic research cycles that were experiential, presentational, propositional, and practical. Themes were developed and framed by a content analysis.Recommendations are presented as a narrative from all the participants involved. The overall theme was 'more focus on personal recovery' with subthemes such as 'CHIME as a recovery-oriented approach'. In addition, other themes were generated such as 'open dialogical meetings', with subthemes such as 'meeting structures' and 'open dialogues'. This study concludes recommendations to promote a recovery-oriented approach in cross-sectoral network meetings inspired by theoretical perspectives along with the experiences and knowledge of co-researchers.
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Affiliation(s)
- Kim Jørgensen
- The Research Collaboration, Psychiatric Centre North Zealand, Hillerød, Denmark
| | - Tonie Rasmussen
- Department of Social and Health, Center for Quality and Development, Birkerød, Denmark
| | - Morten Hansen
- FACT Team 1, Psychiatric Outpatient Clinic, Copenhagen, Denmark
| | - Kate Andreasson
- The Research Collaboration, Psychiatric Centre North Zealand, Hillerød, Denmark
| | - Bengt Karlsson
- Mental Health Care, Center for Mental Health and Substance Abuse, Department of Health, Social and Welfare Studies, Faculty of Health and Social Sciences, Universitetet I Sørøst-Norge, Notodden, Norway
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26
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Hawsawi T, Stein-Parbury J, Orr F, Roche M, Gill K. Exploring recovery-focused educational programmes for advancing mental health nursing: An integrative systematic literature review. Int J Ment Health Nurs 2021; 30 Suppl 1:1310-1341. [PMID: 34231293 DOI: 10.1111/inm.12908] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/18/2021] [Indexed: 01/10/2023]
Abstract
Recovery-focused educational programmes have been implemented in mental health services in an attempt to transform care from a purely biomedical orientation to a more recovery-oriented approach. Mental health nurses have identified the need for enhancing their abilities and confidence in translating recovery knowledge into mental health nursing practice. However, recovery-focused educational programmes have not fully address nurses' learning needs. Therefore, this review synthesized the evidence of the effectiveness of recovery-focused educational programmes for mental health nurses. A systematic search of electronic databases and hand-searched references was conducted. It identified 35 programmes and 55 educational materials within 39 studies. Synthesizing the literature revealed three themes and nine subthemes. The first theme, a framework for understanding and supporting consumers' recovery, had four subthemes: consumers' involvement, multidisciplinary approach, profession-specific training, and performance indicators. The second theme, contents of educational materials, included the subthemes: knowledge development and recovery-focused care planning. The final theme, nurses' learning experiences, included the subthemes: understanding recovery, the positive effects of recovery-focused educational programmes, and implementation of recovery-oriented practices. Based on these findings, a mental health nursing recovery-focused educational programme framework is proposed. Further research should investigate the effectiveness of the framework, especially in relation to recovery-focused care planning and consumer and carer involvement in the development, delivery, participation, and evaluation of these educational programmes.
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Affiliation(s)
- Tahani Hawsawi
- Faculty of Nursing, King Abdul-Aziz University, Jeddah, Saudi Arabia
| | - Jane Stein-Parbury
- School of Nursing and Midwifery, Faculty of Health, University of Technology, Sydney, New South Wales, Australia
| | - Fiona Orr
- School of Nursing and Midwifery, Faculty of Health, University of Technology, Sydney, New South Wales, Australia
| | - Michael Roche
- School of Nursing and Midwifery, Faculty of Health, University of Technology, Sydney, New South Wales, Australia
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Yamaguchi S, Sato S, Shiozawa T, Matsunaga A, Ojio Y, Fujii C. Predictive Association of Low- and High-Fidelity Supported Employment Programs with Multiple Outcomes in a Real-World Setting: A Prospective Longitudinal Multi-site Study. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2021; 49:255-266. [PMID: 34476622 PMCID: PMC8850236 DOI: 10.1007/s10488-021-01161-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE The individual placement and support (IPS) model of supported employment is a leading evidence-based practice in community mental health services. In Japan, individualized supported employment that is highly informed by the philosophy of the IPS model has been implemented. While there is a body of evidence demonstrating the association between program fidelity and the proportion of participants gaining competitive employment, the association between fidelity and a wider set of vocational and individual outcomes has received limited investigation. This study aimed to assess whether high-fidelity individualized supported employment programs were superior to low-fidelity programs in terms of vocational outcomes, preferred job acquisition, and patient-reported outcome measures (PROMs). METHODS A prospective longitudinal study with 24-month follow-up analyzed 16 individualized supported employment programs. The Japanese version of the individualized Supported Employment Fidelity scale (JiSEF) was used to assess the structural quality of supported employment programs (scores: low-fidelity program, ≤ 90; high-fidelity program, ≥ 91). Job acquisition, work tenure, work earnings, job preference matching (e.g., occupation type, salary, and illness disclosure), and PROMs such as the INSPIRE and WHO-Five Well-being index were compared between groups. RESULTS There were 75 and 127 participants in the low-fidelity group (k = 6) and high-fidelity group (k = 10), respectively. The high-fidelity group demonstrated better vocational outcomes than the low-fidelity group, i.e., higher competitive job acquisition (71.7% versus 38.7%, respectively, adjusted odds ratio (aOR) = 3.6, p = 0.002), longer work tenure (adjusted mean difference = 140.8, p < 0.001), and better match for illness disclosure preference (92.6% versus 68.0%, respectively, aOR = 5.9, p = 0.003). However, we found no differences between groups in other preference matches or PROM outcomes. CONCLUSION High-fidelity individualized supported employment programs resulted in good vocational outcomes in a real-world setting. However, enhancing service quality to increase desired job acquisition and improve PROMs will be important in the future. CLINICAL TRIAL REGISTRATION UMIN000025648.
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Affiliation(s)
- Sosei Yamaguchi
- Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan.
| | - Sayaka Sato
- Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan
| | - Takuma Shiozawa
- Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan
| | - Asami Matsunaga
- Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan
| | - Yasutaka Ojio
- Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan
| | - Chiyo Fujii
- Department of Community Mental Health & Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan
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Personal recovery in bipolar disorder: Systematic review and "best fit" framework synthesis of qualitative evidence - a POETIC adaptation of CHIME. J Affect Disord 2021; 292:375-385. [PMID: 34139411 DOI: 10.1016/j.jad.2021.05.051] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 05/10/2021] [Accepted: 05/23/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Personal recovery, living a satisfying, hopeful life alongside symptoms, has become an increasingly valued aim across mental health care agendas internationally. However, there is little understanding of how people experience personal recovery alongside the mood challenges characteristic of a bipolar disorder diagnosis. Personal recovery frameworks have been developed for populations with mixed psychiatric diagnoses, predominantly psychotic disorders. METHODS This systematic review of qualitative data used the widely adopted personal recovery processes Connectedness, Hope and optimism, Identity, Meaning and purpose, Empowerment (CHIME) in a "best fit" framework synthesis to understand personal recovery experiences in bipolar disorder. Included studies were coded with deductive framework analysis based on the CHIME processes and inductive thematic analysis for aspects beyond the a priori framework. RESULTS A comprehensive search of six literature databases led to inclusion of twelve articles published 2010-2020. Deductive coding supported the fit with the CHIME framework but revealed difficulties, losses, and tensions within and across recovery processes. The proposed framework for personal recovery in bipolar disorder, Purpose and meaning, Optimism and hope, Empowerment, Tensions, Identity, Connectedness (POETIC), organises all CHIME processes around these tensions. LIMITATIONS Diversity among study participants was limited with majority middle-aged, female, Western participants. CONCLUSIONS The compact POETIC personal recovery framework tailored for bipolar disorder is directly applicable to clinical practice with personal recovery objectives. It highlights the need for professionals to introduce personal recovery in a realistic and balanced way to address recent criticism by service user organisations of personal recovery as overly optimistic.
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Šaltytė Benth J, Skar-Fröding R, Ruud T, Clausen HK, Heiervang KS. The INSPIRE Support sub-scale: A critical view of the psychometric properties focusing on dimensionality. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01916-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AbstractThe statistical methods previously used for assessing dimensionality of the INSPIRE Support sub-scale are often not valid, which may lead to inaccurate conclusions. The first aim of this paper was to present and discuss the methods for assessing the dimensionality of the scale. The second aim was to illustrate these methods using data from a Norwegian translation of the INSPIRE Support sub-scale. Exploratory factor analysis with several extraction and rotation methods was used to identify the dimensionality of the scale. Cronbach’s alpha and omega coefficient were employed to assess the internal consistency. Using the recognized statistical approach, there was no clear structure found in the Support sub-scale, indicating that the scale might be one-dimensional. While single items or sum score of the INSPIRE Support sub-scale might cover important aspects of the personal recovery concept, there is no evidence of the five CHIME dimensions of this scale as published earlier. A more thorough assessment is called for, and results from studies using the five dimensions should be interpreted with caution.
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Chung-Lung K, Chi-Chiu L, Lai-Ping C, Ching-Kwok L, Chi-Kwong S. Instrumental measurements of recovery-oriented practice in psychiatric services. Asia Pac Psychiatry 2021; 13:e12401. [PMID: 32604466 DOI: 10.1111/appy.12401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 05/25/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION A team of community and rehabilitation staff from a regional mental hospital in Hong Kong has been adopting recovery-oriented practices since 2010 to enhance its services through organizational transformation. The REFOCUS model of the Recovery College of Maudsley Hospital has adopted a tool called INSPIRE, which measures the level of support and relationship. In this study, service users were invited to rate the received support and their relationship with service providers to benchmark our current service before we fully implement the REFOCUS model of practice. METHODS INSPIRE was translated into traditional Chinese. Service users were invited to use C-INSPIRE to score one service provider with whom they had the most frequent contact or had the closest relationship. RESULTS A total of 147 subjects were recruited from different service units at different phases of organizational transformation in recovery-oriented practice. Significantly higher scores in the Relationship Subscale (P = .028) were obtained by units that had introduced recovery-oriented practice for a longer period. However, the overall INSPIRE scores in the Support and Relationship Subscales achieved by Kwai Chung Hospital were 60 and 70, respectively, which were lower than those recorded (72 and 78, respectively) in a study conducted in the United Kingdom. This indicates that there is considerable room for improvement in the delivery of recovery-oriented practice at Kwai Chung Hospital. DISCUSSION With further training and implementation of REFOCUS for all staff, service users' experience in their recovery can be more empowering and satisfying.
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Affiliation(s)
- Kong Chung-Lung
- Community, Day & Out-patient, Occupational Therapy Department, Kwai Chung Hospital, New Territories, Hong Kong
| | - Lee Chi-Chiu
- Department of Psychiatry, Community Psychiatric Service, Kwai Chung Hospital, New Territories, Hong Kong
| | - Chiu Lai-Ping
- Community, Day & Out-patient, Occupational Therapy Department, Kwai Chung Hospital, New Territories, Hong Kong
| | - Li Ching-Kwok
- Department of Psychiatry, Community Psychiatric Service, Kwai Chung Hospital, New Territories, Hong Kong
| | - Sin Chi-Kwong
- Department of Nursing, EXITERS, Day Rehabilitation Service, Kwai Chung Hospital, New Territories, Hong Kong
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Skar-Fröding R, Clausen HK, Šaltytė Benth J, Ruud T, Slade M, Sverdvik Heiervang K. The Importance of Personal Recovery and Perceived Recovery Support Among Service Users With Psychosis. Psychiatr Serv 2021; 72:661-668. [PMID: 33882681 DOI: 10.1176/appi.ps.202000223] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE More knowledge is needed about whether personal recovery, as defined by the CHIME framework (connectedness, hope, identity, meaning and purpose, and empowerment), is considered important by service users with psychosis. This study examined the importance of personal recovery for a large, heterogeneous group of service users with psychosis and their perceived support from clinicians for personal recovery. METHODS This cross-sectional study used baseline data from 321 service users with psychosis from 39 clinical units across Norway. The INSPIRE Measure of Staff Support for Personal Recovery (based on CHIME) was used to examine personal recovery and perceived support provided for recovery. Twenty support-for-recovery items were each rated on importance (yes or no) and on the extent of support received (5-point scale). Bivariate and multiple linear regression models assessed variables associated with rated importance and support. Results: Most service users rated personal recovery items as important, regardless of their symptomatology and functioning. Previous experience with Illness Management and Recovery, knowledge about coping with stress and illness, and having a plan for early detection and prevention of relapse were significantly associated with higher perceived support. Higher self-reported depressive symptoms, lower score on the Global Assessment of Functioning symptom subscale, and male sex were significantly associated with less perceived support. CONCLUSIONS Most service users with psychosis found personal recovery important, regardless of symptomatology and functioning, which has implications for clinical practice and provides empirical evidence that recovery-oriented treatments are relevant for most service users with psychosis in various mental health services.
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Affiliation(s)
- Regina Skar-Fröding
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway (Skar-Fröding, Clausen, Ruud, Sverdvik Heiervang); Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders and Mental Health Division, Innlandet Hospital Trust, Brumunddal (Clausen); Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo (Šaltytė Benth, Ruud); Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway (Šaltytė Benth); Institute of Mental Health, School of Health Sciences, University of Nottingham, Nottingham, United Kingdom (Slade); Centre for Medical Ethics, Faculty of Medicine, University of Oslo, Oslo (Sverdvik Heiervang)
| | - Hanne Kristin Clausen
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway (Skar-Fröding, Clausen, Ruud, Sverdvik Heiervang); Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders and Mental Health Division, Innlandet Hospital Trust, Brumunddal (Clausen); Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo (Šaltytė Benth, Ruud); Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway (Šaltytė Benth); Institute of Mental Health, School of Health Sciences, University of Nottingham, Nottingham, United Kingdom (Slade); Centre for Medical Ethics, Faculty of Medicine, University of Oslo, Oslo (Sverdvik Heiervang)
| | - Jūratė Šaltytė Benth
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway (Skar-Fröding, Clausen, Ruud, Sverdvik Heiervang); Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders and Mental Health Division, Innlandet Hospital Trust, Brumunddal (Clausen); Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo (Šaltytė Benth, Ruud); Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway (Šaltytė Benth); Institute of Mental Health, School of Health Sciences, University of Nottingham, Nottingham, United Kingdom (Slade); Centre for Medical Ethics, Faculty of Medicine, University of Oslo, Oslo (Sverdvik Heiervang)
| | - Torleif Ruud
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway (Skar-Fröding, Clausen, Ruud, Sverdvik Heiervang); Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders and Mental Health Division, Innlandet Hospital Trust, Brumunddal (Clausen); Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo (Šaltytė Benth, Ruud); Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway (Šaltytė Benth); Institute of Mental Health, School of Health Sciences, University of Nottingham, Nottingham, United Kingdom (Slade); Centre for Medical Ethics, Faculty of Medicine, University of Oslo, Oslo (Sverdvik Heiervang)
| | - Mike Slade
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway (Skar-Fröding, Clausen, Ruud, Sverdvik Heiervang); Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders and Mental Health Division, Innlandet Hospital Trust, Brumunddal (Clausen); Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo (Šaltytė Benth, Ruud); Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway (Šaltytė Benth); Institute of Mental Health, School of Health Sciences, University of Nottingham, Nottingham, United Kingdom (Slade); Centre for Medical Ethics, Faculty of Medicine, University of Oslo, Oslo (Sverdvik Heiervang)
| | - Kristin Sverdvik Heiervang
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway (Skar-Fröding, Clausen, Ruud, Sverdvik Heiervang); Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders and Mental Health Division, Innlandet Hospital Trust, Brumunddal (Clausen); Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo (Šaltytė Benth, Ruud); Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway (Šaltytė Benth); Institute of Mental Health, School of Health Sciences, University of Nottingham, Nottingham, United Kingdom (Slade); Centre for Medical Ethics, Faculty of Medicine, University of Oslo, Oslo (Sverdvik Heiervang)
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Relationship between satisfaction with mental health services, personal recovery and quality of life among service users with psychosis: a cross-sectional study. BMC Health Serv Res 2021; 21:439. [PMID: 33964917 PMCID: PMC8105980 DOI: 10.1186/s12913-021-06409-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 04/15/2021] [Indexed: 11/25/2022] Open
Abstract
Background Mental health policy internationally emphasizes patient centredness and personal recovery. This study investigated the relationship between satisfaction with mental health services among service users with psychosis in Norway, and personal recovery, perceived support for personal recovery, and quality of life. Methods Cross-sectional data were collected from 292 service users diagnosed with psychosis from 39 clinical sites across Norway. Satisfaction with services was assessed using the Client Satisfaction Questionnaire-8. A linear mixed model was estimated to explore the relationship between satisfaction with services and preselected covariates, and to control for confounding factors. Results A large majority of participants (89%) reported moderate-to-high levels of satisfaction. Satisfaction with services was positively associated with perceived support for personal recovery, but not with personal recovery or quality of life. In addition, service users under a Community Treatment Order (CTO) were significantly less satisfied than those who were not. Conclusions Satisfaction levels among service users were higher compared with similar, international studies. Those who feel supported in their personal recovery were more satisfied with the care they receive, which support the need for implementation of recovery-oriented practices for service users with psychosis. However, satisfaction with services was not related to service user-rated quality of life or level of personal recovery; thus, more follow-up studies are needed. The lower satisfaction of service users placed under CTOs shows the importance of targeted interventions to improve satisfaction with services among this group. Trial registration NCT03271242, date of registration: 5 sept. 2017.
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Roth C, Wensing M, Koetsenruijter J, Istvanovic A, Novotni A, Tomcuk A, Dedovic J, Djurisic T, Milutinovic M, Kuzman MR, Nica R, Bjedov S, Medved S, Rotaru T, Hipple Walters B, Petrea I, Shields-Zeeman L. Perceived Support for Recovery and Level of Functioning Among People With Severe Mental Illness in Central and Eastern Europe: An Observational Study. Front Psychiatry 2021; 12:732111. [PMID: 34621196 PMCID: PMC8490702 DOI: 10.3389/fpsyt.2021.732111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 08/23/2021] [Indexed: 11/14/2022] Open
Abstract
Background: Many people with severe mental illness experience limitations in personal and social functioning. Care delivered in a person's community that addresses needs and preferences and focuses on clinical and personal recovery can contribute to addressing the adverse impacts of severe mental illness. In Central and Eastern Europe, mental health care systems are transitioning from institutional-based care toward community-based care. The aim of this study is to document the level of functioning and perceived support for recovery in a large population of service users with severe mental illness in Central and Eastern Europe, and to explore associations between perceived support for recovery and the degree of functional limitations. Methods: The implementation of community mental health teams was conducted in five mental health centers in five countries in Central and Eastern Europe. The present study is based on trial data at baseline among service users across the five centers. Baseline data included sociodemographic, the World Health Organization Disability Assessment Schedule (WHODAS 2.0) for functional limitations, and the Recovery Support (INSPIRE) tool for perceived staff support toward recovery. We hypothesized that service users reporting higher levels of perceived support for their recovery would indicate lower levels of functional limitation. Results: Across all centers, the greatest functional limitations were related to participation in society (43.8%), followed by daily life activities (33.3%), and in education or work (35.6%). Service users (N = 931) indicated that they were satisfied overall with the support received from their mental health care provider for their social recovery (72.5%) and that they valued their relationship with their providers (80.3%). Service users who perceived the support they received from their provider as valuable (b = -0.10, p = 0.001) and who reported to have a meaningful relationship with them (b = -0.13, p = 0.003) had a lower degree of functional limitation. Conclusion: As hypothesized, the higher the degree of perceived mental health support from providers, the lower the score in functional limitations. The introduction of the community-based care services that increase contact with service users and consider needs and which incorporate recovery-oriented principles, may improve clinical recovery and functional outcomes of service users with severe mental illness.
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Affiliation(s)
- Catharina Roth
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Marsilius Arcades, Heidelberg, Germany
| | - Michel Wensing
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Marsilius Arcades, Heidelberg, Germany
| | - Jan Koetsenruijter
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Marsilius Arcades, Heidelberg, Germany
| | - Ana Istvanovic
- Croatian Institute of Public Health, Rockefellerova, Zagreb, Croatia
| | - Antoni Novotni
- University St. Cyril and Methodius, University Clinic of Psychiatry, Skopje, North Macedonia
| | - Aleksandr Tomcuk
- Health Institution Special Psychiatric Hospital Dobrota Kotor, Mental Health Promotion and International Cooperation Department and Department of Forensic Psychiatry, Kotor, Montenegro
| | - Jovo Dedovic
- Health Institution Special Psychiatric Hospital Dobrota Kotor, Mental Health Promotion and International Cooperation Department and Department of Forensic Psychiatry, Kotor, Montenegro
| | | | - Milos Milutinovic
- University St. Cyril and Methodius, University Clinic of Psychiatry, Skopje, North Macedonia
| | - Martina Rojnic Kuzman
- Zagreb University Hospital Centre and the Zagreb School of Medicine, Zagreb, Croatia
| | - Raluca Nica
- Institute Liga Romana Pentru Sanatate Mintala, Bucuresti-Sector, Romania
| | - Sarah Bjedov
- Zagreb University Hospital Centre, Clinic for Psychiatry and Psychological Medicine, Zagreb, Croatia
| | - Sara Medved
- Zagreb University Hospital Centre, Clinic for Psychiatry and Psychological Medicine, Zagreb, Croatia
| | - Tiberiu Rotaru
- Siret Psychiatric Hospital, Psychotherapy Unit, Siret, Romania
| | - Bethany Hipple Walters
- Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Department of Mental Health Prevention and Expertise Centre for Tobacco Control, Utrecht, Netherlands
| | - Ionela Petrea
- INSIGHT International Institute for Mental Health and Integrated Health Systems, Amsterdam, Netherlands
| | - Laura Shields-Zeeman
- Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Department of Mental Health Prevention and Expertise Centre for Tobacco Control, Utrecht, Netherlands
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McPherson P, Lloyd-Evans B, Dalton-Locke C, Killaspy H. A Systematic Review of the Characteristics and Efficacy of Recovery Training for Mental Health Staff: Implications for Supported Accommodation Services. Front Psychiatry 2021; 12:624081. [PMID: 34054593 PMCID: PMC8160251 DOI: 10.3389/fpsyt.2021.624081] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 04/09/2021] [Indexed: 11/13/2022] Open
Abstract
Evidence suggests a link between recovery-oriented practise and service user outcomes in supported accommodation settings. Current clinical guidelines recommend recovery training for supported accommodation staff, however evidence relating to the effectiveness of this type of training is unclear. This review aimed to describe and compare the characteristics and efficacy of existing recovery training packages for mental health staff. The appropriateness and applicability of the interventions was considered in relation to UK supported accommodation services. Initial search processes returned 830 papers. After duplicate removal, inclusion and exclusion criteria were applied to 489 papers, leaving a final sample of seven papers. Data were reviewed using a narrative synthesis approach. The reviewed papers showed variation in the aims, frequency, and duration of the training interventions, although all included content consistent with the five-domains of the CHIME model. All interventions used direct, in-person teaching, and prioritised interactive, experiential learning, however a number were limited by the absence of feedback, the use of one-off, rather than repeated/follow-up sessions, and a reliance on classroom-based, rather than in-vivo, training. There was limited evidence to suggest a consistent effect of training on staff or service user outcomes, and there was no clear association between the delivery and design characteristics of the interventions and reported outcomes. In considering the development of recovery training for supported accommodation staff, little guidance can be taken from the reviewed literature. Any training package must be developed with consideration of the unique contextual and organisational characteristics of these services. The authors recommend viewing training as one component of a broader goal of service transformation.
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Durbin A, Nisenbaum R, Wang R, Hwang SW, Kozloff N, Stergiopoulos V. Recovery Education for Adults Transitioning From Homelessness: A Longitudinal Outcome Evaluation. Front Psychiatry 2021; 12:763396. [PMID: 34880792 PMCID: PMC8645597 DOI: 10.3389/fpsyt.2021.763396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 10/26/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: Grounded in principles of adult education, Recovery Education Centres (RECs) hold promise in promoting recovery for adults with mental health challenges, but research on recovery outcomes for hard-to-reach populations participating in RECs is scant. This quasi-experimental study compares 12-month recovery outcomes of adults with histories of homelessness and mental health challenges enrolled in a REC, to those of participants of other community services for this population. Methods: This pre-post quasi-experimental study compared participants enrolled in a REC for people with histories of homelessness and mental health challenges (n = 92) to an age-and-gender frequency matched control group participating in usual services (n = 92) for this population in Toronto, Ontario. Changes from program enrollment to 12 months in personal empowerment (primary outcome), disease specific quality of life, recovery, health status, health related quality of life, and mastery were assessed. Post-hoc analyses compared subgroups with 1-13 h (n = 37) and 14+ h (n = 37) of REC participation during the study period to the control group. Linear mixed models estimated mean changes and differences in mean changes and 95% confidence intervals. Results: Mean change in perceived empowerment from program enrollment to 12 months in the intervention group [0.10 (95% CI: 0.04, 0.15)] was not significantly different from the control group [0.05 (-0.01, 0.11)], mean difference, 0.05 [(-0.03, 0.13), P = 0.25]. In the post-hoc analysis, the mean change in perceived empowerment for the intervention subgroup with 14+ h of REC participation [0.18 (0.10, 0.26)] was significantly different than in the control group [0.05 (-0.01, 0.11)] mean difference, 0.13 [(0.03, 0.23), P < 0.01]. Mean change in mastery was also significantly different for the intervention subgroup with 14+ h of REC participation [2.03 (1.04, 3.02)] vs. controls [0.60 (-0.15, 1.35)], mean difference, 1.43 [(0.19, 2.66), P = 0.02]. There were no significant differences in other outcomes. Conclusion: With sufficient hours of participation, recovery education may be a helpful adjunct to health and social services for adults with mental health challenges transitioning from homelessness.
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Affiliation(s)
- Anna Durbin
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Institute for Clinical Evaluatives Sciences, Toronto, ON, Canada
| | - Rosane Nisenbaum
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.,Applied Health Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Ri Wang
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Stephen W Hwang
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.,Division of General Internal Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Nicole Kozloff
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Institute for Clinical Evaluatives Sciences, Toronto, ON, Canada.,Slaight Centre for Youth in Transition, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Vicky Stergiopoulos
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Institute for Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada.,Centre for Addiction and Mental Health, Toronto, ON, Canada
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Mehta VS, Ram D. A Mixed-Methods Approach to Evaluate the Needs, Support, and Services for Common Mental Disorders: A Protocol Examining Two Community Extension Clinics. Indian J Psychol Med 2020; 42:S57-S62. [PMID: 33487804 PMCID: PMC7802027 DOI: 10.1177/0253717620971985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The social, economic, and physical environments are widely recognized as important determinants of health and affect the outcome of service delivery. The differences in the patient outcomes can be inferred upon by looking into the process and content of service delivery. METHODS This study is a mixed-methods, prospective cohort study to be conducted at two community extension clinics run by the Central Institute of Psychiatry, Ranchi, Jharkhand. Service users diagnosed with a common mental disorder (CMDs) will be recruited during the study period of three years. The main objective is to ascertain the unmet needs of patients with CMDs. The secondary goals involve measuring the clinical outcome through the lens of process-oriented recovery, service satisfaction, and accessibility, and analyzing the barriers to access healthcare services along with the impact on the carers. Focus group discussions with participants will help understand the reasons behind their unmet needs and factors essential in service delivery. DISCUSSION Healthcare, as well as social care, aims to deliver services according to need. In a country with 15 million people with CMDs, evaluation of needs could create a platform for the rational distribution of services.
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Affiliation(s)
- Varun S. Mehta
- Central Institute of Psychiatry, Kanke, Ranchi, Jharkhand, India
- Varun S Mehta, Central Institute of Psychiatry, Kanke, Ranchi, Jharkhand 834006, India. E-mail:
| | - Daya Ram
- Central Institute of Psychiatry, Kanke, Ranchi, Jharkhand, India
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Curth NK, Brinck-Claussen UØ, Hjorthøj C, Davidsen AS, Mikkelsen JH, Lau ME, Lundsteen M, Csillag C, Christensen KS, Jakobsen M, Bojesen AB, Nordentoft M, Eplov LF. Collaborative care for depression and anxiety disorders: results and lessons learned from the Danish cluster-randomized Collabri trials. BMC FAMILY PRACTICE 2020; 21:234. [PMID: 33203365 PMCID: PMC7673096 DOI: 10.1186/s12875-020-01299-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 10/26/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Meta-analyses suggest that collaborative care (CC) improves symptoms of depression and anxiety. In CC, a care manager collaborates with a general practitioner (GP) to provide evidence-based care. Most CC research is from the US, focusing on depression. As research results may not transfer to other settings, we developed and tested a Danish CC-model (the Collabri-model) for depression, panic disorder, generalized anxiety disorder, and social anxiety disorder in general practice. METHODS Four cluster-randomized superiority trials evaluated the effects of CC. The overall aim was to explore if CC significantly improved depression and anxiety symptoms compared to treatment-as-usual at 6-months' follow-up. The Collabri-model was founded on a multi-professional collaboration between a team of mental-health specialists (psychiatrists and care managers) and GPs. In collaboration with GPs, care managers provided treatment according to a structured plan, including regular reassessments and follow-up. Treatment modalities (cognitive behavioral therapy, psychoeducation, and medication) were offered based on stepped care algorithms. Face-to-face meetings between GPs and care managers took place regularly, and a psychiatrist provided supervision. The control group received treatment-as-usual. Primary outcomes were symptoms of depression (BDI-II) and anxiety (BAI) at 6-months' follow-up. The incremental cost-effectiveness ratio (ICER) was estimated based on 6-months' follow-up. RESULTS Despite various attempts to improve inclusion rates, the necessary number of participants was not recruited. Seven hundred thirty-one participants were included: 325 in the depression trial and 406 in the anxiety trials. The Collabri-model was implemented, demonstrating good fidelity to core model elements. In favor of CC, we found a statistically significant difference between depression scores at 6-months' follow-up in the depression trial. The difference was not significant at 15-months' follow-up. The anxiety trials were pooled for data analysis due to inadequate sample sizes. At 6- and 15-months' follow-up, there was a difference in anxiety symptoms favoring CC. These differences were not statistically significant. The ICER was 58,280 Euro per QALY. CONCLUSIONS At 6 months, a significant difference between groups was found in the depression trial, but not in the pooled anxiety trial. However, these results should be cautiously interpreted as there is a risk of selection bias and lacking statistical power. TRIAL REGISTRATION ClinicalTrials.gov, ID: NCT02678624 and NCT02678845 . Retrospectively registered on 7 February 2016.
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Affiliation(s)
- Nadja Kehler Curth
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Mental Health Services, Gentofte Hospitalsvej 15, 2900, Hellerup, Denmark.
| | - Ursula Ødum Brinck-Claussen
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Mental Health Services, Gentofte Hospitalsvej 15, 2900, Hellerup, Denmark
| | - Carsten Hjorthøj
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Mental Health Services, Gentofte Hospitalsvej 15, 2900, Hellerup, Denmark
- Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
| | - Annette Sofie Davidsen
- The Research Unit for General Practice and Section of General Practice, University of Copenhagen, Øster Farimagsgade 5, Postbox 2099, 1014, Copenhagen K, Denmark
| | - John Hagel Mikkelsen
- Mental Health Center Frederiksberg, Mental Health Services, Nordre Fasanvej 57-59, 2000, Frederiksberg, Denmark
| | - Marianne Engelbrecht Lau
- Stolpegård Psychotherapy Center, Mental Health Services, Stolpegårdsvej 20, 2820, Gentofte, Denmark
| | | | - Claudio Csillag
- Mental Health Center North Zealand, Mental Health Services, Dyrehavevej 48, 3400, Hillerød, Denmark
| | - Kaj Sparle Christensen
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Research Unit for General Practice, Institute of Public Health, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark
| | - Marie Jakobsen
- VIVE - The Danish Center for Social Science Research, Herluf Trolles Gade 11, 1052, Copenhagen K, Denmark
| | - Anders Bo Bojesen
- VIVE - The Danish Center for Social Science Research, Herluf Trolles Gade 11, 1052, Copenhagen K, Denmark
| | - Merete Nordentoft
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Mental Health Services, Gentofte Hospitalsvej 15, 2900, Hellerup, Denmark
- Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Lene Falgaard Eplov
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Mental Health Services, Gentofte Hospitalsvej 15, 2900, Hellerup, Denmark
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Keetharuth AD, Bjorner JB, Barkham M, Browne J, Croudace T, Brazier J. An item response theory analysis of an item pool for the recovering quality of life (ReQoL) measure. Qual Life Res 2020; 30:267-276. [PMID: 32909162 PMCID: PMC7847872 DOI: 10.1007/s11136-020-02622-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2020] [Indexed: 02/06/2023]
Abstract
Purpose ReQoL-10 and ReQoL-20 have been developed for use as outcome measures with individuals aged 16 and over, experiencing mental health difficulties. This paper reports modelling results from the item response theory (IRT) analyses that were used for item reduction. Methods From several stages of preparatory work including focus groups and a previous psychometric survey, a pool of items was developed. After confirming that the ReQoL item pool was sufficiently unidimensional for scoring, IRT model parameters were estimated using Samejima’s Graded Response Model (GRM). All 39 mental health items were evaluated with respect to item fit and differential item function regarding age, gender, ethnicity, and diagnosis. Scales were evaluated regarding overall measurement precision and known-groups validity (by care setting type and self-rating of overall mental health). Results The study recruited 4266 participants with a wide range of mental health diagnoses from multiple settings. The IRT parameters demonstrated excellent coverage of the latent construct with the centres of item information functions ranging from − 0.98 to 0.21 and with discrimination slope parameters from 1.4 to 3.6. We identified only two poorly fitting items and no evidence of differential item functioning of concern. Scales showed excellent measurement precision and known-groups validity. Conclusion The results from the IRT analyses confirm the robust structure properties and internal construct validity of the ReQoL instruments. The strong psychometric evidence generated guided item selection for the final versions of the ReQoL measures. Electronic supplementary material The online version of this article (10.1007/s11136-020-02622-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Jakob Bue Bjorner
- Optum Patient Insights, Rhode Island, United States and University of Copenhagen, Copenhagen, Denmark
| | - Michael Barkham
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - John Browne
- School of Public Health, University College Cork, Cork, Ireland
| | - Tim Croudace
- School of Health Sciences, University of Dundee, Dundee, UK
| | - John Brazier
- School of Health and Related Research, University of Sheffield, Sheffield, UK
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Moran GS, Kalha J, Mueller-Stierlin AS, Kilian R, Krumm S, Slade M, Charles A, Mahlke C, Nixdorf R, Basangwa D, Nakku J, Mpango R, Ryan G, Shamba D, Ramesh M, Ngakongwa F, Grayzman A, Pathare S, Mayer B, Puschner B. Peer support for people with severe mental illness versus usual care in high-, middle- and low-income countries: study protocol for a pragmatic, multicentre, randomised controlled trial (UPSIDES-RCT). Trials 2020; 21:371. [PMID: 32357903 PMCID: PMC7195705 DOI: 10.1186/s13063-020-4177-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 02/17/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Peer support is an established intervention involving a person recovering from mental illness supporting others with mental illness. Peer support is an under-used resource in global mental health. Building upon comprehensive formative research, this study will rigorously evaluate the impact of peer support at multiple levels, including service user outcomes (psychosocial and clinical), peer support worker outcomes (work role and empowerment), service outcomes (cost-effectiveness and return on investment), and implementation outcomes (adoption, sustainability and organisational change). METHODS UPSIDES-RCT is a pragmatic, parallel-group, multicentre, randomised controlled trial assessing the effectiveness of using peer support in developing empowering mental health services (UPSIDES) at four measurement points over 1 year (baseline, 4-, 8- and 12-month follow-up), with embedded process evaluation and cost-effectiveness analysis. Research will take place in a range of high-, middle- and low-income countries (Germany, UK, Israel, India, Uganda and Tanzania). The primary outcome is social inclusion of service users with severe mental illness (N = 558; N = 93 per site) at 8-month follow-up, measured with the Social Inclusion Scale. Secondary outcomes include empowerment (using the Empowerment Scale), hope (using the HOPE scale), recovery (using Stages of Recovery) and health and social functioning (using the Health of the Nations Outcome Scales). Mixed-methods process evaluation will investigate mediators and moderators of effect and the implementation experiences of four UPSIDES stakeholder groups (service users, peer support workers, mental health workers and policy makers). A cost-effectiveness analysis examining cost-utility and health budget impact will estimate the value for money of UPSIDES peer support. DISCUSSION The UPSIDES-RCT will explore the essential components necessary to create a peer support model in mental health care, while providing the evidence required to sustain and eventually scale-up the intervention in different cultural, organisational and resource settings. By actively involving and empowering service users, UPSIDES will move mental health systems toward a recovery orientation, emphasising user-centredness, community participation and the realisation of mental health as a human right. TRIAL REGISTRATION ISRCTN, ISRCTN26008944. Registered on 30 October 2019.
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Affiliation(s)
- Galia S. Moran
- The Charlotte B. and Jack J. Spitzer Department of Social Work, Ben Gurion University of the Negev, Be’er Sheva, Israel
| | - Jasmine Kalha
- Centre for Mental Health Law and Policy, Indian Law Society, Pune, India
| | | | - Reinhold Kilian
- Department of Psychiatry and Psychotherapy II, Ulm University, Ulm, Germany
| | - Silvia Krumm
- Department of Psychiatry and Psychotherapy II, Ulm University, Ulm, Germany
| | - Mike Slade
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Ashleigh Charles
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Candelaria Mahlke
- Department of Psychiatry, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Rebecca Nixdorf
- Department of Psychiatry, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | | | - Juliet Nakku
- Butabika National Referral Hospital, Kampala, Uganda
| | | | - Grace Ryan
- Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Donat Shamba
- Ifakara Health Institute, Dar es Salaam, Tanzania
| | - Mary Ramesh
- Ifakara Health Institute, Dar es Salaam, Tanzania
| | | | - Alina Grayzman
- The Charlotte B. and Jack J. Spitzer Department of Social Work, Ben Gurion University of the Negev, Be’er Sheva, Israel
| | - Soumitra Pathare
- Centre for Mental Health Law and Policy, Indian Law Society, Pune, India
| | - Benjamin Mayer
- Institute for Medical Biometry and Epidemiology, Ulm University, Ulm, Germany
| | - Bernd Puschner
- Department of Psychiatry and Psychotherapy II, Ulm University, Ulm, Germany
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Shields-Zeeman L, Petrea I, Smit F, Walters BH, Dedovic J, Kuzman MR, Nakov V, Nica R, Novotni A, Roth C, Tomcuk A, Wijnen BFM, Wensing M. Towards community-based and recovery-oriented care for severe mental disorders in Southern and Eastern Europe: aims and design of a multi-country implementation and evaluation study (RECOVER-E). Int J Ment Health Syst 2020; 14:30. [PMID: 32336984 PMCID: PMC7178587 DOI: 10.1186/s13033-020-00361-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 04/11/2020] [Indexed: 11/29/2022] Open
Abstract
Background Substantial strides have been made around the world in reforming mental health systems by shifting away from institutional care towards community-based services. Despite an extensive evidence base on what constitutes effective care for people with severe mental ill-health, many people in Europe do not have access to optimal mental health care. In an effort to consolidate previous efforts to improve community mental health care and support the complex transition from hospital-based to community-based care delivery, the RECOVER-E (LaRge-scalE implementation of COmmunity based mental health care for people with seVere and Enduring mental ill health in EuRopE) project aims to implement and evaluate multidisciplinary community mental health teams in five countries in Central and Eastern Europe. This paper provides a brief overview of the RECOVER-E project and its methods. Methods Five implementation sites were selected (Sofia, Bulgaria; Zagreb, Croatia; Skopje, North Macedonia; Kotor, Montenegro; Siret-Suceava, Romania) where hospital-based mental health services are available (care as usual, CAU) for patients with severe mental disorders (severe depression, bipolar disorder, schizophrenia). The intervention consists of the introduction of a new service delivery model in each site, consisting of community-based recovery-oriented care delivered by trained multidisciplinary community mental health teams (including a peer worker with lived experience of a severe mental disorder). The implementation outcomes of the teams and the effect of the team’s approach on patient and service utilisation outcomes will be evaluated using a mix of research methods. The study includes five planned hybrid implementation-effectiveness trials (1 per site) with patient-level randomization (n = 180, with patients randomised to either care as usual or intervention condition). Effectiveness is evaluated using a pragmatic non-blinded design with patients randomised into two parallel groups: receiving new community-based care or receiving usual care in the form of institutional, hospital-based mental health care. Trial-based health economic evaluation will be conducted; implementation outcomes will be evaluated, with data aligned with dimensions from the RE-AIM framework. Pathways to sustaining project results will be developed through policy dialogue sessions, which will be carried out in each country and through ongoing policy engagement activities at the European level. Discussion The RECOVER-E project has been developed and conducted to demonstrate the impact of implementing an evidence-based service delivery model for people with severe mental illness in different contexts in middle-income countries in Central and Eastern Europe. It is expected that the results will contribute to the growing evidence-base on the health and economic benefits of recovery-oriented and community-based service models for health systems in transition. Trial registration Each trial was registered before participant enrolment in the clinicaltrials.gov database: Site—Croatia, Zagreb (Trial Reg. No. NCT03862209); Montenegro, Kotor (Trial Reg. No. NCT03837340); Romania, Suceava (Trial Reg. No. NCT03884933); Macedonia, Skopje (Trial Reg. No. NCT03892473); Bulgaria, Sofia (Trial Reg. No. NCT03922425)
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Affiliation(s)
- Laura Shields-Zeeman
- 1Trimbos Institute (Netherlands Institute of Mental Health and Addiction), P.O. Box 725, 3500 AS Utrecht, The Netherlands.,3Department of Public Mental Health and Prevention, Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands
| | - Ionela Petrea
- 1Trimbos Institute (Netherlands Institute of Mental Health and Addiction), P.O. Box 725, 3500 AS Utrecht, The Netherlands
| | - Filip Smit
- 2Centre for Economic Evaluation, Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands.,3Department of Public Mental Health and Prevention, Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands.,4Department of Biostatistics and Epidemiology and Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Bethany Hipple Walters
- 1Trimbos Institute (Netherlands Institute of Mental Health and Addiction), P.O. Box 725, 3500 AS Utrecht, The Netherlands
| | - Jovo Dedovic
- Special Psychiatric Hospital Dobrota, Kotor, Montenegro
| | | | - Vladimir Nakov
- 7National Center for Public Health Analyses, Sofia, Bulgaria
| | - Raluca Nica
- Romanian League for Mental Health, Bucharest, Romania
| | - Antoni Novotni
- 9University Clinic of Psychiatry, Skopje, North Macedonia
| | - Catharina Roth
- 10Department of General Practice and Health Service Research, University Hospital Heidelberg, Heidelberg, Germany
| | | | - Ben F M Wijnen
- 2Centre for Economic Evaluation, Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands
| | - Michel Wensing
- 10Department of General Practice and Health Service Research, University Hospital Heidelberg, Heidelberg, Germany
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Nesse L, Gonzalez MT, Aamodt G, Raanaas RK. Recovery, quality of life and issues in supported housing among residents with co-occurring problems: a cross-sectional study. ADVANCES IN DUAL DIAGNOSIS 2020. [DOI: 10.1108/add-10-2019-0014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Recovery for residents who experience co-occurring problems and live in supported housing takes place in everyday contexts. This study aims to explore residents’ self-reported recovery and quality of life and examine the relationships between these factors and issues in supported housing.
Design/methodology/approach
A cross-sectional study was conducted at 21 supported housing sites in six cities across Norway. A total of 104 residents (76 men and 28 women) responded to measures of recovery (Recovery Assessment Scale – Revised), life satisfaction (Manchester Short Assessment of Quality of Life), affect (single items), staff support (Brief INSPIRE) and sense of home (single items).
Findings
Linear regression analyses indicated associations between recovery and staff support (B = 0.01, 95% CI = 0.01-0.02, ß = 0.39), housing satisfaction (B = 0.15, 95% CI = 0.07-0.22, ß = 0.38), sense of home (B = 0.23, 95% CI = 0.14-0.32, ß = 0.49) and satisfaction with personal economy (B = 0.11, 95% CI = 0.05-0.17, ß = 0.33). Similarly, associations were found between life satisfaction and staff support (B = 0.03, 95% CI = 0.02-0.04, ß = 0.46), housing satisfaction (B = 0.63, 95% CI = 0.46-0.80, ß = 0.60), sense of home (B = 0.65, 95% CI = 0.42-0.87, ß = 0.51) and satisfaction with personal economy (B = 0.34, 95% CI = 0.19-0.50, ß = 0.39).
Originality/value
The findings imply that core issues in supported housing, namely, staff support, housing satisfaction, sense of home and satisfaction with personal economy, are associated with recovery and quality of life.
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Not the story you want? Assessing the fit of a conceptual framework characterising mental health recovery narratives. Soc Psychiatry Psychiatr Epidemiol 2020; 55:295-308. [PMID: 31654089 PMCID: PMC7612149 DOI: 10.1007/s00127-019-01791-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 10/09/2019] [Indexed: 01/03/2023]
Abstract
PURPOSE Narratives of recovery have been central to the development of the recovery approach in mental health. However, there has been a lack of clarity around definitions. A recent conceptual framework characterised recovery narratives based on a systematic review and narrative synthesis of existing literature, but was based on a limited sample. The aims of this study were to assess the relevance of the framework to the narratives of more diverse populations, and to develop a refined typology intended to inform narrative-based research, practice and intervention development. METHOD 77 narrative interviews were conducted with respondents from four under-researched mental health sub-populations across England. Deductive and inductive analysis was used to assess the relevance of the dimensions and types of the preliminary typology to the interview narratives. RESULTS Five or more dimensions were identifiable within 97% of narratives. The preliminary typology was refined to include new definitions and types. The typology was found not to be relevant to two narratives, whose narrators expressed a preference for non-verbal communication. These are presented as case studies to define the limits of the typology. CONCLUSION The refined typology, based on the largest study to date of recovery narratives, provides a defensible theoretical base for clinical and research use with a range of clinical populations. Implications for practice include ensuring a heterogeneous selection of narratives as resources to support recovery, and developing new approaches to supporting non-verbal narrative construction.
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Ibrahim N, Thompson D, Nixdorf R, Kalha J, Mpango R, Moran G, Mueller-Stierlin A, Ryan G, Mahlke C, Shamba D, Puschner B, Repper J, Slade M. A systematic review of influences on implementation of peer support work for adults with mental health problems. Soc Psychiatry Psychiatr Epidemiol 2020; 55:285-293. [PMID: 31177310 DOI: 10.1007/s00127-019-01739-1] [Citation(s) in RCA: 87] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 06/03/2019] [Indexed: 12/25/2022]
Abstract
PURPOSE The evidence base for peer support work in mental health is established, yet implementation remains a challenge. The aim of this systematic review was to identify influences which facilitate or are barriers to implementation of mental health peer support work. METHODS Data sources comprised online databases (n = 11), journal table of contents (n = 2), conference proceedings (n = 18), peer support websites (n = 2), expert consultation (n = 38) and forward and backward citation tracking. Publications were included if they reported on implementation facilitators or barriers for formal face-to-face peer support work with adults with a mental health problem, and were available in English, French, German, Hebrew, Luganda, Spanish or Swahili. Data were analysed using narrative synthesis. A six-site international survey [Germany (2 sites), India, Israel, Tanzania, Uganda] using a measure based on the strongest influences was conducted. The review protocol was pre-registered (Prospero: CRD42018094838). RESULTS The search strategy identified 5813 publications, of which 53 were included. Fourteen implementation influences were identified, notably organisational culture (reported by 53% of papers), training (42%) and role definition (40%). Ratings on a measure using these influences demonstrated preliminary evidence for the convergent and discriminant validity of the identified influences. CONCLUSION The identified influences provide a guide to implementation of peer support. For services developing a peer support service, organisational culture including role support (training, role clarity, resourcing and access to a peer network) and staff attitudes need to be considered. The identified influences provide a theory base to prepare research sites for implementing peer support worker interventions.
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Affiliation(s)
- Nashwa Ibrahim
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Triumph Road, Nottingham, NG7 2TU, UK.,Psychiatric and Mental Health Nursing Department, Faculty of Nursing, Mansoura University, Mansoura, Egypt
| | - Dean Thompson
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Triumph Road, Nottingham, NG7 2TU, UK
| | - Rebecca Nixdorf
- Department of Psychiatry, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Jasmine Kalha
- Centre for Mental Health Law and Policy, Indian Law Society, Pune, India
| | | | - Galia Moran
- Ben Gurion University of the Negev, Beer Sheva, Israel
| | | | - Grace Ryan
- London School of Hygiene and Tropical Medicine, London, UK
| | | | | | | | - Julie Repper
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | - Mike Slade
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Triumph Road, Nottingham, NG7 2TU, UK.
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Kotake R, Kanehara A, Miyamoto Y, Kumakura Y, Sawada U, Takano A, Chiba R, Ogawa M, Kondo S, Kasai K, Kawakami N. Reliability and validity of the Japanese version of the INSPIRE measure of staff support for personal recovery in community mental health service users in Japan. BMC Psychiatry 2020; 20:51. [PMID: 32028913 PMCID: PMC7006071 DOI: 10.1186/s12888-020-2467-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 01/27/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Supporting personal recovery in people with mental health difficulties is central to mental health services. This study aimed to develop the Japanese version of INSPIRE and Brief INSPIRE measure of staff support for personal recovery and to evaluate its reliability and validity. METHODS A questionnaire survey was conducted from October to December 2015. The authors asked users to participate in the survey of 14 community mental health services in the Kanto region of Japan. The service users completed self-administered questionnaires that include the Japanese version of INSPIRE, the Recovery Assessment Scale, the Client Satisfaction Questionnaire, the patient version of the Scale to Assess Therapeutic Relationship in Community Mental Health care and the Short Form Health Survey. Internal consistency was assessed using Cronbach's alpha coefficient, and test-retest reliability was assessed using the intraclass correlation coefficient (ICC) and weighted kappa. Convergent validity was examined by assessing correlation with other scales. Factor validity was evaluated by exploratory factor analysis (EFA) with generalized least-squares mean and oblimin rotation. In addition, confirmatory factor analysis was used to check the fitness of the factor structure models derived from the EFA. RESULTS A total of 195 out of 212 users gave written informed consent and participated in the study. Data from 190 respondents were analyzed (response rate 89.6%). INSPIRE, Brief INSPIRE, and the subscales all showed Cronbach's alpha coefficient over 0.78. ICC and weighted kappa derived more than 0.92 for subscales and Brief INSPIRE. These numerical values indicated good reliability. The convergent validity of Brief INSPIRE and the subscales was significantly positively correlated with the other scales. Different from the previous study, the factor structure was extracted using EFA. Both factor structures were checked by CFA, but the degree of fitness index was not good in either. Therefore, the factor analysis did not show goodness of fit. CONCLUSIONS This study found the Japanese version of INSPIRE and Brief INSPIRE to be reliable and valid for use among community mental health service users in Japan.
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Affiliation(s)
- Risa Kotake
- grid.26999.3d0000 0001 2151 536XDepartment of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, 113-0033 Japan
| | - Akiko Kanehara
- grid.26999.3d0000 0001 2151 536XDepartment of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, 113-8655 Japan
| | - Yuki Miyamoto
- Department of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, 113-0033, Japan.
| | - Yousuke Kumakura
- grid.26999.3d0000 0001 2151 536XDepartment of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, 113-0033 Japan
| | - Utako Sawada
- grid.26999.3d0000 0001 2151 536XDepartment of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, 113-0033 Japan
| | - Ayumi Takano
- grid.265073.50000 0001 1014 9130Department of Mental Health and Psychiatric Nursing, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo, 113-8510 Japan
| | - Rie Chiba
- grid.31432.370000 0001 1092 3077Department of Nursing, Graduate School of Health Sciences, Kobe University, 7-10-2, Tomogaoka, Suma-ku, Kobe, Hyogo 654-0142 Japan
| | - Makoto Ogawa
- grid.419280.60000 0004 1763 8916National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi, Kodaira, Tokyo, 187-8553 Japan
| | - Shinsuke Kondo
- grid.412708.80000 0004 1764 7572Department of Neuropsychiatry, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo, Tokyo, 113-8655 Japan
| | - Kiyoto Kasai
- grid.412708.80000 0004 1764 7572Department of Neuropsychiatry, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo, Tokyo, 113-8655 Japan ,grid.26999.3d0000 0001 2151 536XThe International Research Center for Neurointelligence (WPI-IRCN), The University of Tokyo Institutes for Advanced Study (UTIAS), 7-3-1 Hongo, Bunkyo, Tokyo, 113-0033 Japan
| | - Norito Kawakami
- grid.26999.3d0000 0001 2151 536XDepartment of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo, 113-0033 Japan
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Penas P, Uriarte JJ, Gorbeña S, Moreno-Calvete MC, Ridgway P, Iraurgi I. Psychometric Adequacy of Recovery Enhancing Environment (REE) Measure: CHIME Framework as a Theory Base for a Recovery Measure. Front Psychiatry 2020; 11:595. [PMID: 32714217 PMCID: PMC7344157 DOI: 10.3389/fpsyt.2020.00595] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 06/09/2020] [Indexed: 12/23/2022] Open
Abstract
PURPOSE The aim of this study was to assess to what extent the recovery elements of the Recovery Enhancing Environment (REE) instrument measured the dimensions proposed by the CHIME framework, (Connectedness, Hope and optimism about future, Identity, Meaning in life and Empowerment dimensions), so as to evaluate personal recovery in people with severe mental illness. METHODS Two processes were conducted. Firstly, five experts matched the elements of recovery evaluated by the REE items with the CHIME domains and subdomains. Then, the resulting structure from those experts agreement was analyzed with different confirmatory factor analyses (CFA) using responses to the recovery elements dimension of the REE of 312 mental health service users. RESULTS The percentage of agreements and the kappa coefficients were adequate taking into account the CHIME dimensions (κ = 0.57 to 0.69, total κ = 0.74); however, lower agreement was found at the subdimensions level. Some indexes of the CFA were acceptable for a second order factor analysis [χ 2 (242)= 346.03, p < 0.001, CFI= 0.931, RMSEA= 0.037 (0.028 to 0.046)] and the most adequate solution was obtained from the bi-factorial structure (χ 2 (223)=233.19, p=0.306, CFI= 0.993, RMSEA= 0.012 [0.000 to 0.027]). CONCLUSIONS Despite the subjective and complex nature of the personal recovery construct, the REE measure can be a valid instrument to verify the existing CHIME conceptual framework, since two of the models tested have resulted in adequate indexes and were also congruent with the theoretical framework and the statistical solution. Thus, REE can be used to obtain a global index of Personal Recovery dimension, and the five indicators proposed by the CHIME framework.
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Affiliation(s)
- Patricia Penas
- Department of Personality, Assessment and Psychological Treatment, University of Deusto, Bilbao, Spain
| | - Jose Juan Uriarte
- Red de Salud Mental, Biocruces Bizkaia Health Research Institute, Basque Health Service, Bizkaia Mental Health Network, Bilbao, Spain
| | - Susana Gorbeña
- Department of Personality, Assessment and Psychological Treatment, University of Deusto, Bilbao, Spain
| | - Maria Concepcion Moreno-Calvete
- Red de Salud Mental, Biocruces Bizkaia Health Research Institute, Basque Health Service, Bizkaia Mental Health Network, Bilbao, Spain
| | | | - Ioseba Iraurgi
- Department of Personality, Assessment and Psychological Treatment, University of Deusto, Bilbao, Spain
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Curth NK, Brinck-Claussen U, Jørgensen KB, Rosendal S, Hjorthøj C, Nordentoft M, Eplov LF. Collaborative care vs consultation liaison for depression and anxiety disorders in general practice: study protocol for two randomized controlled trials (the Danish Collabri Flex trials). Trials 2019; 20:607. [PMID: 31653228 PMCID: PMC6814969 DOI: 10.1186/s13063-019-3657-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 08/13/2019] [Indexed: 01/18/2023] Open
Abstract
Background Models of collaborative care and consultation liaison propose organizational changes to improve the quality of care for people with common mental disorders, such as anxiety and depression. Some literature suggests only short-term positive effects of consultation liaison on patient-related outcomes, whereas collaborative care demonstrates both short-term and long-term positive effects. To our knowledge, only one randomized trial has compared the effects of these models. Collaborative care was superior to consultation liaison in reducing symptoms of depression for up to 3 months, but the authors found no difference at 9-months' follow-up. The Collabri Flex Trial for Depression and the Collabri Flex Trial for Anxiety aim to compare the effects of collaborative care with those of a form of consultation liaison that contains potential contaminating elements from collaborative care. The trials build on knowledge from the previous cluster-randomized Collabri trials. Methods Two randomized, investigator-initiated, parallel-group, superiority trials have been established: one investigating the effects of collaborative care vs consultation liaison for depression and one investigating the effects of collaborative care vs consultation liaison for generalized anxiety, panic disorder and social anxiety disorder at 6-months' follow-up. Participants are recruited from general practices in the Capital Region of Denmark: 240 in the depression trial and 284 in the anxiety trial. The primary outcome is self-reported depression symptoms (Beck Depression Inventory (BDI-II)) in the depression trial and self-reported anxiety symptoms (Beck Anxiety Inventory (BAI)) in the anxiety trial. In both trials, the self-reported secondary outcomes are general psychological problems and symptoms (Symptom Checklist 90-Revised), functional impairment (Sheehan Disability Scale) and general well-being (World Health Organization-Five Well-Being Index). In the depression trial, BAI is an additional secondary outcome, and BDI-II is an additional secondary outcome in the anxiety trial. Explorative outcomes will also be collected. Discussion The results will supplement those of the cluster-randomized Collabri trials and provide pivotal information about the effects of collaborative care in Denmark. Trial registration ClinicalTrials.gov, NCT03113175 and NCT03113201. Registered on 13 April 2017. Electronic supplementary material The online version of this article (10.1186/s13063-019-3657-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nadja Kehler Curth
- Research Unit, Mental Health Center Copenhagen, Mental Health Services, Capital Region of Denmark, Kildegårdsvej 28, 15A, 4th floor, DK-2900, Hellerup, Denmark.
| | - Ursula Brinck-Claussen
- Research Unit, Mental Health Center Copenhagen, Mental Health Services, Capital Region of Denmark, Kildegårdsvej 28, 15A, 4th floor, DK-2900, Hellerup, Denmark
| | - Kirstine Bro Jørgensen
- Research Unit, Mental Health Center Copenhagen, Mental Health Services, Capital Region of Denmark, Kildegårdsvej 28, 15A, 4th floor, DK-2900, Hellerup, Denmark
| | - Susanne Rosendal
- Mental Health Center Copenhagen, Mental Health Services, Capital Region of Denmark, Nordre Fasanvej 59, Vej 5, 12, 2nd floor, DK-2000, Frederiksberg, Denmark
| | - Carsten Hjorthøj
- Research Unit, Mental Health Center Copenhagen, Mental Health Services, Capital Region of Denmark, Kildegårdsvej 28, 15A, 4th floor, DK-2900, Hellerup, Denmark
| | - Merete Nordentoft
- Research Unit, Mental Health Center Copenhagen, Mental Health Services, Capital Region of Denmark, Kildegårdsvej 28, 15A, 4th floor, DK-2900, Hellerup, Denmark
| | - Lene Falgaard Eplov
- Research Unit, Mental Health Center Copenhagen, Mental Health Services, Capital Region of Denmark, Kildegårdsvej 28, 15A, 4th floor, DK-2900, Hellerup, Denmark
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Wewiorski NJ, Gorman JA, Ellison ML, Hunt MG, Evans L, Charns MP. A site visit protocol for assessing recovery promotion at the program level: An example from the Veterans Health Administration. Psychiatr Rehabil J 2019; 42:323-328. [PMID: 31233322 PMCID: PMC6741775 DOI: 10.1037/prj0000369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE A site visit protocol was developed to assess recovery promotion in the organizational climate and culture of programs for veterans with serious mental illnesses. METHOD The protocol was pilot-tested in 4 programs: 2 that had scored high on the pilot version of a staff survey measure of program-level recovery promotion and 2 that had scored low. Two-person teams conducted onsite visits and assigned global and organizational domain ratings. Interrater agreement was assessed by examining adjacent agreement and computing weighted kappa. RESULTS The on-site protocol had good interrater agreement and discriminated between sites that scored high and low on the staff survey. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE This site visit protocol and procedure shows promise for evaluating recovery promotion in milieu-based programs. After further refinement of this tool, adaptations could be developed for accreditation protocols or for program self-assessment and quality improvement efforts. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Nancy J Wewiorski
- Center for Healthcare Organization and Implementation Research (CHOIR)
| | - Jay A Gorman
- Social and Community Reintegration Research Program (SoCRR), Bedford VA Medical Center
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Durbin A, Kapustianyk G, Nisenbaum R, Wang R, Aratangy T, Khan B, Stergiopoulos V. Recovery education for people experiencing housing instability: An evaluation protocol. Int J Soc Psychiatry 2019; 65:468-478. [PMID: 31250692 DOI: 10.1177/0020764019858650] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Recovery education centers (RECs) offer recovery supports through education rather than traditional health services. The Supporting Transitions and Recovery Learning Centre (STAR) in Toronto, Canada, is among the few that are internationally focused on individuals with histories of homelessness. Although research suggests that RECs positively impact participants, there is a paucity of rigorous studies and none address the engagement and impacts on homeless individuals. AIMS This protocol describes a realist-informed evaluation of STAR, specifically examining (1) if STAR participation is more effective in promoting 12-month recovery outcomes than participation in usual services for individuals experiencing housing instability and mental health challenges and (2) how STAR participation promotes recovery and other positive outcomes. METHODS This study uses a quasi-experimental mixed methods design. Personal empowerment (primary outcome) and recovery, housing stability, social functioning, health service use and quality of life (secondary outcomes) data were collected at baseline, and 6 and 12 months. Intervention group participants were recruited at the time of STAR registration while control group participants were recruited from community agencies serving this population after screening for age and histories of housing instability. Interviews and focus groups with service users and providers will identify the key intervention ingredients that support the process of recovery. RESULTS From January 2017 to July 2018, 92 individuals were recruited to each of the intervention and control groups. The groups were mostly similar at baseline; the intervention group's total empowerment score was slightly higher than the control group's (M (SD): 2.94 (0.23) vs 2.84 (0.28), p = .02), and so was the level of education. A subset of STAR participants (n = 20) and nine service providers participated in the qualitative interviews and focus groups. CONCLUSION This study will offer important new insights into the effectiveness of RECs, and expose how key REC ingredients support the process of recovery for people experiencing housing instability.
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Affiliation(s)
- Anna Durbin
- 1 Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada.,2 Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,3 Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | - Grace Kapustianyk
- 1 Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada
| | - Rosane Nisenbaum
- 1 Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada.,4 Department of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Ri Wang
- 1 Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada
| | - Tatiana Aratangy
- 1 Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada
| | - Bushra Khan
- 2 Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Vicky Stergiopoulos
- 1 Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada.,2 Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,5 Centre for Addiction and Mental Health, Toronto, ON, Canada
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Recovery-oriented training programmes for mental health professionals: A narrative literature review. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.mhp.2019.01.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Waldemar AK, Esbensen BA, Korsbek L, Petersen L, Arnfred S. Recovery-oriented practice: Participant observations of the interactions between patients and health professionals in mental health inpatient settings. Int J Ment Health Nurs 2019; 28:318-329. [PMID: 30151987 DOI: 10.1111/inm.12537] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/05/2018] [Indexed: 11/30/2022]
Abstract
Despite an increasing attention towards recovery orientation in the mental health services, the provision of recovery-oriented practice is challenged in the inpatient wards. Moreover, the existing research within this area is modest and we currently have limited knowledge of how recovery-oriented practice is integrated into inpatient settings. A cornerstone of recovery-oriented practice is the collaboration, patient involvement, and choices, particularly when deciding and planning treatment options. Thus, this ethnographic study aimed to explore how recovery-oriented practice is reflected in the interactions between patients and health professionals around treatment in two mental health inpatient wards in Denmark. Participant observations were conducted in two mental health inpatient wards from November 2014 to January 2015. The Recovery Self-Assessment scale inspired the observation guide and the initial data analysis. Field notes were analysed deductively and inductively using qualitative content analysis. One theme with four subthemes emerged showing that interactions were characterized by an 'as-if collaboration' where 'negotiating on limited grounds' was an important feature of interactions, in which health professionals seemed to have superiority, acting on behalf of 'competing demands'. Patients had to navigate in a field of 'inconsistent guidance and postponed decisions' and faced tendencies of 'control and condescending communication'. The results suggest that recovery oriented values such as equal collaboration, choice and patients' personal preferences are reflected rhetorically in the interactions between patients and health professionals. However, they are negotiated within organizational logics and often overruled by competing demands.
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Affiliation(s)
- Anna Kristine Waldemar
- Competence Centre for Rehabilitation and Recovery, Mental Health Centre Ballerup, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
| | - Bente Appel Esbensen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Copenhagen Centre for Arthritis Research, Centre for Rheumatology and Spine Diseases VRR, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark
| | - Lisa Korsbek
- Competence Centre for Rehabilitation and Recovery, Mental Health Centre Ballerup, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
| | - Lone Petersen
- Competence Centre for Rehabilitation and Recovery, Mental Health Centre Ballerup, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
| | - Sidse Arnfred
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Psychiatry West, Psychiatric Hospital Slagelse, Region Zealand Mental Health Services, Slagelse, Denmark
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