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Occupational evaluation of community-based psychiatric rehabilitation outcomes in individuals with severe mental illnesses: A ten-year retrospective study. Asian J Psychiatr 2023; 81:103450. [PMID: 36630832 DOI: 10.1016/j.ajp.2023.103450] [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: 10/20/2022] [Revised: 11/20/2022] [Accepted: 01/05/2023] [Indexed: 01/07/2023]
Abstract
BACKGROUND There is a lack of research on the effect of community-based psychiatric rehabilitation programs (CBPRs) in individuals with severe mental illness. This research used data from a retrospective study to examine the effect of a CBPR in a community rehabilitation center. MATERIALS AND METHODS Clinical outcomes measures from a retrospective study were collected. Outcome measures were the Allen Cognitive Level Screen assessment, Purdue Pegboard Test, Chu's Attention Test, and Activities of Daily Living Rating Scale-III (ADLRS-III) before and immediately after 12 months of intervention. RESULTS The 141 participants with mental illness were an average age of 35.29 years (SD = 8.75). The retrospective review of medical records showed 46 people dropped out within 12 months, and 95 people continued to participate in the rehabilitation program for 1 year. After 1 year of community rehabilitation, there was a trend for the participants who completed the intervention to improve on the ADLRS-III, Purdue Pegboard Test, and Chu's Attention Test. Participants who performed better on the occupational assessment were more likely to transit to the employment status. CONCLUSION This study found the benefits of CBPR in work-related intervention for people with mental illness. Occupational assessments are relevant for studying changes in functional outcomes in people with mental illness receiving community-based rehabilitation.
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Yang Z, Lee SH, Abdul Rashid NA, See YM, Dauwels J, Tan BL, Lee J. Predicting Real-World Functioning in Schizophrenia: The Relative Contributions of Neurocognition, Functional Capacity, and Negative Symptoms. Front Psychiatry 2021; 12:639536. [PMID: 33815171 PMCID: PMC8017150 DOI: 10.3389/fpsyt.2021.639536] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 02/08/2021] [Indexed: 11/13/2022] Open
Abstract
Neurocognition and functional capacity are commonly reported predictors of real-world functioning in schizophrenia. However, the additional impact of negative symptoms, specifically its subdomains, i.e., diminished expression (DE) and avolition-apathy (AA), on real-world functioning remains unclear. The current study assessed 58 individuals with schizophrenia. Neurocognition was assessed with the Brief Assessment of Cognition in Schizophrenia, functional capacity with the UCSD Performance-based Skills Assessment (UPSA-B), and negative symptoms with the Negative Symptom Assessment-16. Real-world functioning was assessed with the Multnomah Community Ability Scale (MCAS) with employment status as an additional objective outcome. Hierarchical regressions and sequential logistic regressions were used to examine the associations between the variables of interest. The results show that global negative symptoms contribute substantial additional variance in predicting MCAS and employment status above and beyond the variance accounted for by neurocognition and functional capacity. In addition, both AA and DE predict the MCAS after controlling for cognition and functional capacity. Only AA accounts for additional variance in employment status beyond that by UPSA-B. In summary, negative symptoms contribute substantial additional variance in predicting both real-world functioning and employment outcomes after accounting for neurocognition and functional capacity. Our findings emphasize both DE and AA as important treatment targets in functional recovery for people with schizophrenia.
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Affiliation(s)
- Zixu Yang
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Soon Hong Lee
- Research Division, Institute of Mental Health, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | | | - Yuen Mei See
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Justin Dauwels
- School of Electrical and Electronic Engineering, Nanyang Technological University, Singapore, Singapore
| | - Bhing Leet Tan
- Department of Occupational Therapy, Institute of Mental Health, Singapore, Singapore.,Health and Social Sciences, Singapore Institute of Technology, Singapore, Singapore
| | - Jimmy Lee
- Research Division, Institute of Mental Health, Singapore, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.,Department of Psychosis, Institute of Mental Health, Singapore, Singapore
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Mattei G, Venturi G, Alfieri S, Colombini N, Ferrari S, Rigatelli M, Starace F, Galeazzi GM. Clinical and Socio-demographic Variables Associated with the Outcome of Vocational Rehabilitation Programs: A Community-Based Italian Study. Community Ment Health J 2020; 56:1380-1390. [PMID: 32086675 DOI: 10.1007/s10597-020-00577-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 02/11/2020] [Indexed: 10/25/2022]
Abstract
This study aims to identify clinical and socio-demographic variables associated with the outcome of vocational rehabilitation programs (VRPs). All users of an Italian Community Mental Health Centre (CMHC) included in VRPs delivered according to the model of Supported Employment in years 2011-2016 were retrospectively enrolled. Fifty users who ended the program with employment were compared with fifty users who dropped out, with respect to clinical and socio-demographic variables. VRPs lasting less than 6 months and oriented toward the competitive labor market had a higher probability of employment. Among users who successfully ended the VRP, the median of health interventions significantly decreased after employment. In the same group of users, less non-health interventions strictly linked to the VRP were required, when compared with users who dropped out. We conclude that employment is associated with improvement of users' clinical conditions and reduced workload for the CMHC.
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Affiliation(s)
- G Mattei
- Department of Biomedical, Metabolic and Neural Sciences, Section of Clinical Neurosciences, University of Modena and Reggio Emilia, Modena, Italy. .,Ph.D. School in Labor, Development and Innovation, "Marco Biagi" Department of Economics & Marco Biagi Foundation, University of Modena and Reggio Emilia, Modena, Italy. .,Association for Research in Psychiatry, Castelnuovo Rangone, Modena, Italy.
| | - G Venturi
- Department of Biomedical, Metabolic and Neural Sciences, Section of Clinical Neurosciences, University of Modena and Reggio Emilia, Modena, Italy
| | - S Alfieri
- Department of Mental Health & Drug Abuse, AUSL Modena, Modena, Italy
| | - N Colombini
- Department of Mental Health & Drug Abuse, AUSL Modena, Modena, Italy
| | - S Ferrari
- Department of Biomedical, Metabolic and Neural Sciences, Section of Clinical Neurosciences, University of Modena and Reggio Emilia, Modena, Italy.,Department of Mental Health & Drug Abuse, AUSL Modena, Modena, Italy
| | - M Rigatelli
- Department of Biomedical, Metabolic and Neural Sciences, Section of Clinical Neurosciences, University of Modena and Reggio Emilia, Modena, Italy
| | - F Starace
- Department of Mental Health & Drug Abuse, AUSL Modena, Modena, Italy
| | - G M Galeazzi
- Department of Biomedical, Metabolic and Neural Sciences, Section of Clinical Neurosciences, University of Modena and Reggio Emilia, Modena, Italy.,Department of Mental Health & Drug Abuse, AUSL Modena, Modena, Italy
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Kuek JHL, Raeburn T, Wand T. Asian perspectives on personal recovery in mental health: a scoping review. J Ment Health 2020; 32:517-533. [PMID: 32915681 DOI: 10.1080/09638237.2020.1818709] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Personal recovery is a relatively novel concept in many Asian countries, and recovery-oriented interventions are usually adapted from western conceptualizations of recovery. AIM To understand what personal recovery in mental health means to people in Asia, what meanings they give to their conditions, and what factors they perceive as hindering or facilitating their recovery. METHOD The review focused on peer-reviewed papers published in English between the years 2000 and 2020. Arksey and O'Malley 5-stage method was used to guide the review. RESULTS Thirty studies were included. Personal recovery in Asia meant a return to a pre-illness state and involved a transformative process. Mental illness was explained as being biomedically oriented, although religious/culturally bound explanations were also present in some studies. Social support, religion, meaningful activities, supportive professionals, and personalized coping strategies were viewed as supporting recovery. Religious stigma, discrimination, gendered norms, and negative societal perceptions of mental illness hindered recovery. CONCLUSIONS The concept of personal recovery in Asia is extremely diverse. Studies exploring personal recovery among people experiencing mental illness in Asia remains in its early stages and more research is needed to better understand how it is conceptualized. Such knowledge could benefit frontline implementation of recovery-oriented services.
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Affiliation(s)
- Jonathan Han Loong Kuek
- Susan Wakil School of Nursing and Midwifery
- Sydney Nursing School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Toby Raeburn
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia
| | - Timothy Wand
- Susan Wakil School of Nursing and Midwifery
- Sydney Nursing School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Heard CP, Scott J, Tetzlaff A, Lumley H. Transitional housing in forensic mental health: considering consumer lived experience. HEALTH & JUSTICE 2019; 7:8. [PMID: 31111290 PMCID: PMC6717971 DOI: 10.1186/s40352-019-0091-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 05/02/2019] [Indexed: 05/22/2023]
Abstract
BACKGROUND For individuals involved in the forensic mental health system, access to transitional housing can offer a bridge between custody and independence. Using a methodology consistent with interpretative phenomenological analysis (IPA), this study considers the meaning associated with such participation. In this Canadian study, data was collected via interview with six individuals (n = 6) who resided, for a minimum six (6) months, in justice focused transitional housing that involved a partnership between a rural forensic mental health care facility and a nearby urban transitional housing provider. RESULTS Following each participant interview, data was transcribed verbatim and coded for themes. Multiple methods were employed to support trustworthiness. Results indicate that participation enabled enhanced social participation, self-esteem/efficacy, community integration and renewal of daily living skills. Participants identified that involvement in justice focused transitional housing enabled development of community living skills, cultivated self-confidence and enhanced personal resilience in their transition from a secure forensic mental health facility to more independent community tenure. CONCLUSIONS Participants in this research clearly identified the importance of transitional housing programs in supporting their move from a forensic mental health facility to the community. Not all forensic involved individuals will need this type or level of support to support their transition. Practically, however, the nature of forensic hospitalization can present real challenges for occupational participation and maintenance of community living skills. Transitional housing, accountable to unique forensic mental health and justice inputs, can offer a valuable bridge to the community.
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Affiliation(s)
- Clark Patrick Heard
- Southwest Centre for Forensic Mental Health Care, School of Occupational Therapy, Western University, 401 Sunset Drive, St. Thomas, Ontario N5P 3V9 Canada
- Lawson Health Research Institute, London, Canada
| | - Jared Scott
- Southwest Centre for Forensic Mental Health Care, School of Occupational Therapy, Western University, 401 Sunset Drive, St. Thomas, Ontario N5P 3V9 Canada
- Lawson Health Research Institute, London, Canada
| | - Allan Tetzlaff
- Southwest Centre for Forensic Mental Health Care, School of Occupational Therapy, Western University, 401 Sunset Drive, St. Thomas, Ontario N5P 3V9 Canada
- Lawson Health Research Institute, London, Canada
| | - Heather Lumley
- St. Leonard’s Community Services, London and Region, 405 Dundas Street, London, Ontario N6B 1V9 Canada
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