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Liu Y, Li Y. Community participation and subjective perception of recovery and quality of life among people with serious mental illnesses: the mediating role of self-stigma. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02754-7. [PMID: 39249511 DOI: 10.1007/s00127-024-02754-7] [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: 04/19/2024] [Accepted: 08/28/2024] [Indexed: 09/10/2024]
Abstract
PURPOSE Community participation is believed to be positively associated with recovery experiences and quality of life for people with serious mental illnesses (PSMIs). However, the underlying mechanism remains unclear. This study examined the mediating effect of self-stigma on the relationship between community participation and personal recovery experiences and quality of life among PSMIs. METHODS Structural equation modeling and mediation analyses were conducted based on a community sample of 315 PSMIs in Beijing, China, who were surveyed using the Community Participation Domains Measure, Internalized Stigma of Mental Illness, Recovery Assessment Scale, Quality of Life Scale, and a demographic questionnaire. Most were in their middle age. About half were married, and half were females. Most participants got disability certificates. RESULTS The results indicate that community participation is directly associated with personal recovery of PSMIs (P < 0.01) and indirectly associated with personal recovery through the mediation of self-stigma (P < 0.01). Additionally, community participation does not have a direct effect on the quality of life of PSMIs but shows an indirect effect through the mediation of self-stigma (P < 0.01). The findings suggest that self-stigma mediates the relationship between community participation and both the subjective perception of recovery and quality of life. CONCLUSION The findings indicate that community participation for PSMIs should be enhanced. Tailored individual intervention services should be implemented to boost positive self-awareness and reduce self-stigma through active engagement in activities. Such participation has the potential to improve subjective experiences of recovery and overall quality of life.
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Affiliation(s)
- Ying Liu
- Department of Medical Psychology, School of Medical Humanities, Capital Medical University, Beijing, China
| | - Ying Li
- Department of Social Security, School of Labor and Human Resources, Renmin University of China, Haidian District, Beijing, 100872, China.
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Parker S, Chapman M, Wyder M, Pommeranz M, Walgers R, Dark F, Meurk C. Life is better but not without challenges: experiences following discharge from community-based residential mental health rehabilitation-a qualitative content analysis. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02716-z. [PMID: 39012385 DOI: 10.1007/s00127-024-02716-z] [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: 01/17/2024] [Accepted: 06/24/2024] [Indexed: 07/17/2024]
Abstract
PURPOSE Community-based residential mental health rehabilitation units for people experiencing severe and persistent mental illness are increasingly available in Australia. Research completed 20 years ago suggested that people leaving these services often experienced impoverished social lives and other challenges in the community. It is unclear whether contemporary consumers experience similar difficulties. This qualitative study explored contemporary consumers' experiences after leaving community-based residential services. METHODS An inductive qualitative content analysis of individual interviews was completed with consumers 12-18 months following discharge from three community care units (CCUs) in Queensland, Australia. The interview schedule explored three questions: (1) What does life look like after leaving the CCU, (2) Has the CCU impacted their life, and (3) How could the CCU experience be improved? A convenience sample was used, with sampling continuing until thematic saturation was achieved. A member of the research team who had relevant lived experience actively supported the analysis and interpretation. RESULTS Seventeen interviews were completed. Three themes were identified: 'life is better but not without challenges', 'the CCU helps you get ready to go out into the world', and 'strict rules are important but rigid expectations can be hard; things could be better'. CONCLUSION Consumers reflected positively on their lives post-discharge from a community-based residential rehabilitation unit and viewed the service as having supported improvements in their lives. The findings suggest the appropriateness of optimism about the possibility of sustained improvements in quality of life after leaving community-based transitional residential rehabilitation support.
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Affiliation(s)
- Stephen Parker
- Metro South Addiction and Mental Health Service, Woolloongabba, QLD, Australia.
- Faculty of Medicine, University of Queensland, Herston, QLD, Australia.
- Metro North Mental Health, The Prince Charles Hospital, Chermside, QLD, Australia.
- Metro North Mental Health, Royal Brisbane & Womens Hospital, Herston, QLD, 4006, Australia.
| | - Maddison Chapman
- Metro South Addiction and Mental Health Service, Woolloongabba, QLD, Australia
| | - Marianne Wyder
- Metro South Addiction and Mental Health Service, Woolloongabba, QLD, Australia
| | - Matthew Pommeranz
- Metro South Addiction and Mental Health Service, Woolloongabba, QLD, Australia
| | - Rebecca Walgers
- Metro South Addiction and Mental Health Service, Woolloongabba, QLD, Australia
| | - Frances Dark
- Metro South Addiction and Mental Health Service, Woolloongabba, QLD, Australia
- Faculty of Medicine, University of Queensland, Herston, QLD, Australia
| | - Carla Meurk
- Queensland Centre for Mental Health Research, University of Queensland, Wacol, QLD, Australia
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Hegde S, Quadros S, Appaji R, Acharya VA. 'Life Minus Illness = Recovery': A Phenomenological Study About Experiences and Meanings of Recovery Among Individuals with Serious Mental Illness from Southern India. Community Ment Health J 2024:10.1007/s10597-024-01312-4. [PMID: 38965142 DOI: 10.1007/s10597-024-01312-4] [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: 08/04/2023] [Accepted: 06/08/2024] [Indexed: 07/06/2024]
Abstract
Traditional medical models have given way to recovery-oriented approaches over the years in the management of individuals with serious mental illnesses. However, very little is known about such recovery-based models in the Indian context. This qualitative study used a phenomenological approach to explore the experiences and meanings of recovery among individuals with serious mental illness in southern India. Purposive sampling with maximum variation was used to recruit participants. In-depth interviews were conducted with ten participants, using a semi-structured interview guide. Thematic analysis resulted in three themes: "The illness journey," "Life minus illness = Recovery," and "It takes a village to recover,". Illness and recovery seemed to be two sides of the same coin with the context playing an influential role in the perceptions of recovery. The term "recovery" seemed to be a misnomer giving the impression that one is expected to return to an illness free state.
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Affiliation(s)
- Srishti Hegde
- Department of Occupational Therapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Shalini Quadros
- Department of Occupational Therapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Rashmi Appaji
- Department of Psychiatry, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
- Department of Psychiatry, Father Muller Medical College, Mangalore, Karnataka, India
| | - Vinita A Acharya
- Department of Occupational Therapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India.
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Dima A, Wazir A, Clark-Castillo R, Zakopoulos I, Smith S, Gaughran F. Factors influencing the length of stay in forensic psychiatric settings: a systematic review. BMC Health Serv Res 2024; 24:400. [PMID: 38553762 PMCID: PMC10981349 DOI: 10.1186/s12913-024-10863-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 03/13/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Forensic psychiatry is often associated with long admissions and has a high cost of care. There is little known about factors influencing length of stay (LOS), and no previous systematic review has synthesised the available data. This paper aims to identify factors influencing the LOS in forensic psychiatry hospitals to inform care and interventions that may reduce the length of admissions. METHODOLOGY A systematic review was conducted by searching major databases, including PubMed, EMBASE and PsycInfo, from inception until May 2022. Observational studies conducted in forensic hospitals that examined associations between variables of interest and LOS were included. Following data extraction, the Newcastle‒Ottawa Scale was used for quality appraisal. No meta-analysis was conducted due to heterogeneity of information; a quantitative measure to assess the strength of evidence was developed and reported. RESULTS A total of 28 studies met the inclusion criteria out of 1606 citations. A detailed quantitative synthesis was performed using robust criteria. Having committed homicide/attempted homicide, a criminal legal status with restrictions, and a diagnosis of schizophrenia-spectrum disorders were all associated with longer LOS. Higher Global Assessment of Functioning (GAF) scores were associated with a shorter LOS. CONCLUSION High-quality research examining factors associated with LOS in forensic psychiatry is lacking, and studies are heterogeneous. No modifiable characteristics were identified, and thus, practice recommendations were not made. There is an increasing necessity to understand the factors associated with longer admissions to inform care and increase success in reintegration and rehabilitation. This paper provides recommendations for future research.
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Affiliation(s)
- Aikaterini Dima
- South London and Maudsley NHS Foundation Trust, London, UK.
- Institute of Psychiatry Psychology and Neuroscience, London, UK.
| | - Adonis Wazir
- Surrey and Sussex Healthcare NHS Trust, Redhill, UK
- Swansea University, Swansea, UK
| | | | | | - Shubulade Smith
- South London and Maudsley NHS Foundation Trust, London, UK
- Institute of Psychiatry Psychology and Neuroscience, Psychosis Studies, London, UK
| | - Fiona Gaughran
- South London and Maudsley NHS Foundation Trust, London, UK
- Institute of Psychiatry Psychology and Neuroscience, Psychosis Studies, London, UK
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Igarashi M, Kawaguchi T, Shiozawa T, Yamaguchi S. Conversation topics in psychiatric consultations conducted with and without a shared decision-making tool: A qualitative content analysis. PATIENT EDUCATION AND COUNSELING 2024; 118:108045. [PMID: 37925974 DOI: 10.1016/j.pec.2023.108045] [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: 07/13/2023] [Revised: 10/25/2023] [Accepted: 10/29/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVES To identify 1) conversation topics, 2) who initiated the topics, and 3) differences in topics with and without the use of a shared decision-making (SDM) tool in psychiatric outpatient consultations. METHODS We conducted qualitative content analysis of audio-recorded and transcribed data of psychiatric outpatient consultations. We included 52 participants - 25 in the SDM group and 27 in the treatment as usual (TAU) group - and 104 consultations were analyzed, two per participant. The word count per topic was calculated using the transcripts. RESULTS Five categories for 28 topics were generated. The categories and percentages of word count were: (1) symptoms: 26.1%, (2) life: 37.4%, (3) treatment/service use: 16.3%, (4) global state/goal: 7.3%, and (5) others: 12.9%. The SDM tool significantly increased the overall conversation word count and consultation time. No significant difference was observed for the topic distribution between the two groups. CONCLUSION Daily life issues - especially those related to work - were the main topics discussed in psychiatric consultations. The SDM tool seems to facilitate discussion of patients' concerns, but the topic distribution is likely to be similar regardless of whether or not the SDM tool was used. PRACTICE IMPLICATIONS Outpatient psychiatrists are expected to effectively address life-related issues.
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Affiliation(s)
- Momoka Igarashi
- 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
| | - Takayuki Kawaguchi
- 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; Nursing Innovation Research Center, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
| | - 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.
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Bjørkedal STB, Bejerholm U, Hjorthøj C, Møller T, Eplov LF. Meaningful Activities and Recovery (MA&R): a co-led peer occupational therapy intervention for people with psychiatric disabilities. Results from a randomized controlled trial. BMC Psychiatry 2023; 23:406. [PMID: 37280561 DOI: 10.1186/s12888-023-04875-w] [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: 02/24/2023] [Accepted: 05/16/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Activity and participation are critical to health and wellbeing. Limited evidence exists on how to support people with mental illness in participating in everyday activities. AIM To investigate the effectiveness of Meaningful Activities and Recovery (MA&R), a co-led peer occupational therapy intervention focusing on activity engagement, functioning, quality of life, and personal recovery. METHODS In a statistician blinded, multicenter RCT including 139 participants from seven community and municipal mental health services in Denmark, participants were randomly assigned to 1) MA&R and standard mental health care or 2) standard mental health care. The MA&R intervention lasted 8 months and consisted of 11 group sessions, 11 individual sessions, and support to engage in activities. The primary outcome, activity engagement, was measured using Profile of Occupational Engagement in People with Severe Mental Illness (POES-S). Outcomes were measured at baseline and post-intervention follow-up. RESULTS Meaningful Activities and Recovery was delivered with high fidelity and 83% completed the intervention. It did not demonstrate superiority to standard mental health care, as intention-to treat analysis revealed no significant differences between the groups in activity engagement or any of the secondary outcomes. CONCLUSION We did not find positive effects of MA&R, possibly because of COVID-19 and related restrictions. Fidelity assessments and adherence rates suggest that MA&R is feasible and acceptable. However, future studies should focus on refining the intervention before investigating its effectiveness. TRIAL REGISTRATION The trial was registered 24/05/2019 at ClinicalTrials.gov NCT03963245.
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Affiliation(s)
| | - Ulrika Bejerholm
- Department of Health Sciences, Centre of Evidence-Based Psychosocial Interventions, CEPI, Lund University, Lund, Sweden
- Department of Research, Development and Education, Division of Psychiatry and Habilitation, Region Skåne, Lund, Sweden
| | - Carsten Hjorthøj
- CORE: Copenhagen Research for Mental Health, Gentofte Hospitalsvej 15, 3A, 2900, Hellerup, Denmark
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1353, Copenhagen K, Denmark
| | - Tom Møller
- University Hospitals Centre for Health Research (UCSF), Department 9701, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1353, Copenhagen K, Denmark
| | - Lene Falgaard Eplov
- CORE: Copenhagen Research for Mental Health, Gentofte Hospitalsvej 15, 3A, 2900, Hellerup, Denmark
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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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Eklund M, Argentzell E. Implementing an occupational therapy specific mental health intervention in a multi-professional context - the case of Balancing Everyday Life (BEL). Scand J Occup Ther 2023; 30:182-194. [PMID: 34739360 DOI: 10.1080/11038128.2021.1998608] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND The occupation-based intervention Balancing Everyday Life (BEL) was found effective under controlled conditions but should also be studied in a natural clinical practice context. AIM The aim was to study the implementation process of BEL when provided in a multi-professional mental health team. The focus was particularly on how BEL was received and functioned. METHODS This qualitative study was based on manifest content analysis and used semi-structured telephone interviews with 13 occupational therapists and three managers. RESULTS Three themes were identified: '1 - Conditions and opportunities in the setting', '2 - Putting the BEL intervention into practice' and '3 - Experiences of practicing BEL'. BEL was a welcomed alternative, as stated by managers and occupational therapists. The team helped to recruit BEL participants, but the occupational therapists had to give rigorous information to team members and prospective participants for this to work. The social, physical and political contexts were essential for the implementation. CONCLUSIONS Successful implementation of an occupational therapy-specific intervention such as BEL requires a reasonable match between existing team policies and the underpinnings of the intervention. It is crucial to repeat information to all stakeholders and make the intervention a matter of urgency for the whole team.
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Affiliation(s)
- Mona Eklund
- Department of Health Sciences, Mental Health, Activity and Participation (MAP), Lund University, Lund, Sweden
| | - Elisabeth Argentzell
- Department of Health Sciences, Mental Health, Activity and Participation (MAP), Lund University, Lund, Sweden
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Karadzhov D. 'Trials and Tribulations': The Ambivalent Influence of Temporary Accommodation on Mental Health Recovery in Chronically Homeless Adults. QUALITATIVE HEALTH RESEARCH 2023; 33:176-190. [PMID: 36644943 PMCID: PMC9932610 DOI: 10.1177/10497323221147127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Relatively few studies have explicitly examined whether and how shelter-type, temporary or emergency accommodation shapes homeless clients' personal (mental health) recovery. A transatlantic phenomenological qualitative study was conducted to examine the influence of those services on personal recovery. Eighteen chronically homeless adults with a history of serious mental illness were recruited from several temporary accommodation services in New York City (NYC), U.S., and Glasgow, Scotland. Participants completed repeat in-depth interviews and a novel one-week multimedia mobile phone diary. The interpretative phenomenological analysis (IPA) produced three overarching group experiential themes: 'everything was just starting to fall into place'; 'caught in a trap'; and 'trials and tribulations'. Collectively, the findings underscore the duality of influence of temporary accommodation on recovery. Those ambiguous spaces confronted participants with existential uncertainty, volatility and chronic boredom, but also proffered opportunities for envisioning and enacting recovery. Embarking on recovery while residing in temporary accommodation is possible, even for those enduring chronic life adversity. However, it is contingent upon enabling socio-material, affective and relational resources. Implications are discussed for theorising recovery as a contextually embedded, relational phenomenon, and for providing recovery-oriented support across the housing continuum.
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Affiliation(s)
- Dimitar Karadzhov
- Centre for Health Policy, School of
Social Work and Social Policy, University of
Strathclyde, Glasgow, UK
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Ercan Doğu S, Örsel S. The relationship between psychopathology, occupational balance, and quality of life among people with schizophrenia. Aust Occup Ther J 2022. [PMID: 36562348 DOI: 10.1111/1440-1630.12855] [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: 04/30/2022] [Revised: 11/18/2022] [Accepted: 11/28/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE There is an increased risk of occupational imbalance and poor quality of life (QoL) if one has schizophrenia. Although evidence suggests a relationship between psychopathology and QoL, the association of occupational balance (OB) with QoL in schizophrenia is unclear. This study aimed to investigate the associations among psychopathology, occupational balance, and QoL in schizophrenia. METHODS This was a cross-sectional study carried out in a Community Mental Health Center (CMHC). Ninety-five individuals aged 18 years or older with the diagnosis of schizophrenia participated in the study. All participants completed a sociodemographic form, Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale in Schizophrenia (CDSS), Occupational Balance Questionnaire-11 Turkish Version (OBQ11-T), and the World Health Organisation Quality of Life Assessment Instrument (WHOQOL-100-TR). Relationships among clinical and depressive symptoms, OB, and QoL variables were examined through correlation analysis, and then multiple linear regression analysis was performed to determine the variables that have influences on QOL. RESULTS The study participants had low OB scores and the lowest mean in the WHOQOL-social relationships subscale. WHOQOL-overall QoL score demonstrated a moderate negative correlation with the PANSS-total score and PANSS-general psychopathology subscale score (r = -0.422, r = -0.463, P < 0.001) and a mild negative correlation with the CDSS-total score (r = -0.390, P < 0.001). OBQ11-T total score showed a moderate positive correlation with the WHOQOL-overall score (r = 0.549; P < 0.001). Findings from the multiple linear regression analysis revealed that OBQ11-T (β = -0.467, P = 0.000) and PANSS-general psychopathology (β = -0.221, P = 0.045) were significant predictors of the overall QoL, explaining 48% of the variance in the overall QoL (adjusted R2 = .43, P < 0.001). CONCLUSION Our study findings showed that OB and general psychopathology are determinants that should be considered in improving the QoL in individuals with schizophrenia. Thereby, addressing the symptoms of general psychopathology and occupational factors to improve the QoL may be achieved with the incorporation of occupation-based programmes to routine treatment. However, further research is required.
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Affiliation(s)
- Selma Ercan Doğu
- Hamidiye Faculty of Health Sciences, Department of Occupational Therapy, University of Health Sciences, Istanbul, Turkey
| | - Sibel Örsel
- Department of Psychiatry, University of Health Sciences Diskapi Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
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“Moving on to an Open World”: A Study of Participants’ Experience in Meaningful Activities and Recovery (MA&R). Occup Ther Int 2022; 2022:7418667. [DOI: 10.1155/2022/7418667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 10/12/2022] [Accepted: 11/01/2022] [Indexed: 11/09/2022] Open
Abstract
Background. Meaningful activities and Recovery (MA&R) is a peer coled occupational therapy intervention, to support occupational engagement among persons with psychiatric disabilities. Aim. To investigate participants’ perspectives on how MA&R influenced occupational engagement and recovery processes. Material and Methods. A qualitative study with a phenomenological-hermeneutic design. Individual semistructured interviews were conducted with three women and ten men who had participated in MA&R. Participants were recruited from community mental health centres and municipality mental health services in two Danish municipalities. Analysis strategy was based on Malterud’s Systematic Text Condensation. Results. MA&R was perceived as a practical approach to recovery, by providing an opportunity for reorientation, meaning, making in mundane activities, and a new outlook on everyday life. Participating in MA&R challenged a black and white approach to activities, put emphasis on “the little things”, and enhanced curiosity, presence, and joy in occupational engagement. Conclusion. MA&R supported participants in developing a new “lens” on meaningful activities. The lens enhanced occupational engagement and made it possible to live according to personal preference. Results can inform further development and delivery of recovery-oriented occupational therapy interventions and add to the understandings of how occupational engagement and recovery are intertwined and manifested through everyday experiences. Thus, occupational engagement is an important target for recovery-oriented interventions. Occupational therapists and peer-workers coleading such interventions is feasible and makes good sense to the participants.
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Austin SF, Hjorthøj C, Baagland H, Simonsen E, Dam J. Investigating personal and clinical recovery processes in people with first episode psychosis. Early Interv Psychiatry 2022; 16:1102-1111. [PMID: 34825487 DOI: 10.1111/eip.13258] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 10/04/2021] [Accepted: 11/07/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Schizophrenia is a serious mental illness characterized by a range of symptoms such as distortions in reality, emotional abnormalities and deficits in cognition. Recovery from severe mental illness can be conceptualized in a number of ways. Clinical recovery has a focus on symptoms and functioning whilst personal recovery describes the process of developing new meaning and purpose in life beyond mental illness. OBJECTIVE This longitudinal study examined the relationship between clinical and personal recovery processes within a group of people with first episode psychosis (FEP) receiving early intervention treatment over a period of up to 2 years. METHODS The study sequentially recruited people with FEP that accepted into early intervention treatment. Participants were evaluated at baseline, 12 months and completion of treatment for clinical and personal recovery. RESULTS A total of 51 participants were recruited, completed treatment and assessments. Modest but significant correlations (r = 0.38-0.51) were found between personal recovery and certain aspects of clinical recovery (negative symptoms and functioning). Improvements in functioning (vocational and social activities) predicted both personal and clinical recovery whilst negative symptoms predicted attaining clinical recovery. Reductions in negative symptoms (global, apathy and anhedonia) during treatment were associated with moving towards personal recovery. Psychotic symptoms were not significantly associated with the attainment of clinical or personal recovery. CONCLUSIONS Results indicated that clinical and personal recovery are interdependent and complementary processes. Mental health services may need implement interventions that simultaneously target clinical and personal recovery processes in order to meet the treatment needs of people with psychosis.
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Affiliation(s)
- Stephen F Austin
- Psychiatric Research Unit, Psychiatry Region Zealand, Denmark.,Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Carsten Hjorthøj
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Erik Simonsen
- Psychiatric Research Unit, Psychiatry Region Zealand, Denmark.,Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jesper Dam
- Psychiatric Center North Zealand, Hillerød, Denmark
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McIntosh J, Marques B, Jenkin G. The Role of Courtyards within Acute Mental Health Wards: Designing with Recovery in Mind. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11414. [PMID: 36141687 PMCID: PMC9517498 DOI: 10.3390/ijerph191811414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/01/2022] [Accepted: 09/06/2022] [Indexed: 06/16/2023]
Abstract
The role of courtyards and other outdoor spaces in the recovery of acute mental healthcare users has been gaining international appreciation and recognition. However, the physical properties and conditions necessary for therapeutic and rehabilitative engagement remain to be clearly established. This paper contributes to that knowledge by triangulating evidence from the literature, exemplar case studies of good practice and first-hand accounts of the experiences of staff and service users from four acute mental health facilities. The findings are then aligned with a well-established recovery framework (CHIMES) in light of existing landscape architecture knowledge. Within the complexity of varied mental health environments, this work establishes landscape architectural design requirements and qualities essential for recovery. Rather than adopting a prescriptive quantitative approach setting out areas, numbers of elements, etc., the proposed framework recommends a performance-based model and the creation of a cohesive network of microspaces that mesh into a design of outdoor areas. In this way, design details, materials, vegetation and the variety of spaces can be modified to suit service user population demographics and site-specific needs.
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Affiliation(s)
- Jacqueline McIntosh
- Wellington School of Architecture, Victoria University of Wellington, P.O. Box 600, Wellington 6140, New Zealand
| | - Bruno Marques
- Wellington School of Architecture, Victoria University of Wellington, P.O. Box 600, Wellington 6140, New Zealand
| | - Gabrielle Jenkin
- Department of Psychological Medicine, University of Otago, Wellington 23a Mein St., Wellington 6021, New Zealand
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Joyce A, Moussa B, Elmes A, Campbell P, Suchowerska R, Buick F, Barraket J, Carey G. Organisational structures and processes for health and well-being: insights from work integration social enterprise. BMC Public Health 2022; 22:1624. [PMID: 36030204 PMCID: PMC9419331 DOI: 10.1186/s12889-022-13920-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 07/27/2022] [Indexed: 11/10/2022] Open
Abstract
Background Previous research on employee well-being for those who have experienced social and economic disadvantage and those with previous or existing mental health conditions has focused mainly on programmatic interventions. The purpose of this research was to examine how organisational structures and processes (such as policies and culture) influence well-being of employees from these types of backgrounds. Methods A case study ethnographic approach which included in-depth qualitative analysis of 93 semi-structured interviews of employees, staff, and managers, together with participant observation of four social enterprises employing young people. Results The data revealed that young people were provided a combination of training, varied work tasks, psychosocial support, and encouragement to cultivate relationships among peers and management staff. This was enabled through the following elements: structure and space; funding, finance and industry orientation; organisational culture; policy and process; and fostering local service networks.. The findings further illustrate how organisational structures at these workplaces promoted an inclusive workplace environment in which participants self-reported a decrease in anxiety and depression, increased self-esteem, increased self-confidence and increased physical activity. Conclusions Replicating these types of organisational structures, processes, and culture requires consideration of complex systems perspectives on implementation fidelity which has implications for policy, practice and future research.
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Affiliation(s)
- Andrew Joyce
- Centre for Social Impact, Swinburne University of Technology, Mail H25, Cnr John and Wakefield Streets, PO Box 218, Hawthorn, VIC, 3122, Australia.
| | - Batool Moussa
- Centre for Social Impact, Swinburne University of Technology, Mail H25, Cnr John and Wakefield Streets, PO Box 218, Hawthorn, VIC, 3122, Australia
| | - Aurora Elmes
- Centre for Social Impact, Swinburne University of Technology, Mail H25, Cnr John and Wakefield Streets, PO Box 218, Hawthorn, VIC, 3122, Australia
| | - Perri Campbell
- Centre for Social Impact, Swinburne University of Technology, Mail H25, Cnr John and Wakefield Streets, PO Box 218, Hawthorn, VIC, 3122, Australia
| | - Roksolana Suchowerska
- Centre for Social Impact, Swinburne University of Technology, Mail H25, Cnr John and Wakefield Streets, PO Box 218, Hawthorn, VIC, 3122, Australia
| | - Fiona Buick
- School of Business, University of New South Wales, Northcott Drive, Canberra, ACT 2600, Australia
| | - Jo Barraket
- Melbourne Social Equity Institute, University of Melbourne, Grattan Street, Parkville, VIC, 3010, Australia
| | - Gemma Carey
- Centre for Social Impact, University of New South Wales, UNSW Sydney, 704, Level 7, Science Engineering Building, Sydney, NSW, 2052, Australia
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Lindström M, Lindholm L, Liv P. Study protocol for a pragmatic cluster RCT on the effect and cost-effectiveness of Everyday Life Rehabilitation versus treatment as usual for persons with severe psychiatric disability living in sheltered or supported housing facilities. Trials 2022; 23:657. [PMID: 35971130 PMCID: PMC9377097 DOI: 10.1186/s13063-022-06622-0] [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: 11/30/2021] [Accepted: 08/02/2022] [Indexed: 11/24/2022] Open
Abstract
Background People with severe psychiatric disabilities and impaired autonomy, living in sheltered or supported housing facilities, often lead sedentary, solitary lives indoors and have significantly poorer health than others in the population. Meaningful everyday activities are important for the recovery towards an enrichening, agentic, social, and hopeful everyday life. The Everyday Life Rehabilitation (ELR) model—a person-centred activity- and recovery-oriented intervention—has shown positive outcomes in feasibility studies, and thus a randomised controlled trial (RCT) is required to establish the effectiveness of ELR, along with calculations of cost-effectiveness. Methods The ELR-RCT is a pragmatic, two-parallel-armed cluster RCT evaluating the effect and cost-effectiveness of using ELR from two measurement points over 6 months (pre-post intervention) and in three waves over 3 years. The primary outcome is recovering quality of life (ReQoL) at 6 months, and the secondary outcome is self-perceived recovery and daily functioning (RAS-DS) at 6 months. Additionally, Goal Attainment Scaling (GAS) will be used for the intervention group. Power analysis has been conducted for primary outcome measure. The first wave will include an internal pilot, to be evaluated after 6 months, used as basis for decisions on updating the required sample size and any other need for adaptations before continuing with the full-scale RCT in the second and third wave. All municipalities within a geographic area in northern Sweden, with a minimum of one sheltered or supported housing facility for people with severe psychiatric or neuropsychiatric disability, including access to occupational therapy, will be enrolled. Participants will be block-randomised to receive ELR plus treatment as usual (TAU) or TAU alone for a control period. The control group will thereafter receive delayed ELR. Occupational therapists and housing staff will receive an educational package, manuals, and tools, as well as reflections with colleagues during the intervention period. Housing managers will receive questions for monthly follow-up and coaching with staff. Discussion This is a protocol for both an internal pilot and full trial of the first RCT study using the ELR intervention model in sheltered or supported housing facilities, evaluating the effects together with cost-effectiveness. Trial registration ClinicalTrials.gov NCT05056415. Registered on 24 September 2021. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06622-0.
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Affiliation(s)
- Maria Lindström
- Department of Community Medicine and Rehabilitation, Umeå University, 901 87, Umeå, Sweden.
| | - Lars Lindholm
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Per Liv
- Department of Public Health and Clinical Medicine, Umeå university, 901 87, Umeå, Sweden
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Chauhan N, Leeming D, Wattis J. "It's a Big Family Here." Becoming and Belonging in a Service Providing Employment-Related Support for People with Mental Health Problems: An Interpretative Phenomenological Analysis. Community Ment Health J 2022; 58:277-287. [PMID: 33835277 PMCID: PMC8770366 DOI: 10.1007/s10597-021-00819-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 03/26/2021] [Indexed: 11/16/2022]
Abstract
The impact of employment for individuals with mental health problems is complex. However, research suggests that when support is provided for accessing employment and gaining roles and skills that are valued by others, a positive effect can be seen on recovery. Employment-related support can take many forms and there is a need for further research into the experience of accessing different kinds of services. The current paper examines the lived experience of 11 people participating in a UK social enterprise providing work experience, training, and skills development for those with mental health problems. Although 'sheltered', the organisational ethos strongly emphasised service-user empowerment, co-production, equality with staff, provision of valued social roles and person-centred support. Phenomenological analysis revealed that participants valued a sense of belonging and authentic relationships within the service, whilst being given the opportunity to rediscover an identity that may have been lost because of their mental health problem. However, participants also discussed how, although the service improved their self-value, some feared the 'real world' outside of the service and were unsure whether they would be met with the same support. Tensions between field dominant approaches in supported employment and the experiences and values of the participants are explored. We argue that the findings highlight the importance of a nurturing working environment and the value for recovery of a range of meaningful roles, beyond competitive employment.
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Affiliation(s)
- Nisha Chauhan
- University of Huddersfield, Queensgate, Huddersfield, HD1 3DH, UK.
| | - Dawn Leeming
- University of Huddersfield, Queensgate, Huddersfield, HD1 3DH, UK
| | - John Wattis
- University of Huddersfield, Queensgate, Huddersfield, HD1 3DH, UK
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17
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Promoting Sports Engagement during the COVID-19 Pandemic via Virtual Reality Games. Occup Ther Int 2022; 2022:4824152. [PMID: 35140553 PMCID: PMC8808239 DOI: 10.1155/2022/4824152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 12/16/2021] [Indexed: 11/17/2022] Open
Abstract
Objective To examine sports engagement and health changes of young adults when utilizing a VR sports game and investigate the relationship between sports engagement and health. Method This study used a single-group design with 20 participants, aged 19–29 years, with no preexisting health conditions. The VR game “Sports Scramble” was used thrice within a span of one week. Outcomes sought include sports engagement and health, measured through the Sports Engagement Scale (SES) and Short Form 36 (SF-36), respectively. Results A significant difference (p < 0.001) was found between the pre-posttest scores of the SES. Moreover, a positive trend was observed in terms of health with a significant difference (p < 0.05) between pre-posttest scores of the SF-36's vitality dimension. There were positive correlations among the dedication and vigor subscales of the SES with the dimensions of health. Conclusion This study showed the potential of VR sports games in positively influencing sports engagement and health among participants with the vigor and dedication positively influencing health. Future studies may involve the exploration of the effectiveness of VR to promote engagement and health through a randomized controlled trial with a longer timeframe and across various populations.
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18
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Lindström M. Development of the Everyday Life Rehabilitation model for persons with long-term and complex mental health needs: Preliminary process findings on usefulness and implementation aspects in sheltered and supported housing facilities. Front Psychiatry 2022; 13:954068. [PMID: 36051549 PMCID: PMC9424656 DOI: 10.3389/fpsyt.2022.954068] [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: 05/26/2022] [Accepted: 07/15/2022] [Indexed: 11/13/2022] Open
Abstract
UNLABELLED This paper describes the initial phases of the design and development of the Everyday Life Rehabilitation (ELR) intervention, and it presents preliminary findings on usefulness and implementation aspects derived from an ongoing larger trial exploring the effect, cost-effectiveness, and usefulness of ELR. ELR is a model designed to meet the absence of meaningful activities and challenges with integrated, activity- and recovery-oriented rehabilitation in sheltered and supported housing facilities for persons with extensive psychiatric disabilities. The aim of the present study was to examine early experiences of implementing the ELR model from the perspectives of managers, housing staff, and occupational therapists. The paper will sum up preliminary findings based on process data included in an internal pilot prior to a full-scale pragmatic clustered RCT. Four Swedish municipalities with 19 housing facility units were involved and provided process data for the study. Thematic analysis were applied. The informants perceived the methodology to be well suited to the target group and context and to contribute to positive changes in participants' lives. The web-based training was also experienced as relevant and easily accessible to staff, as well as elements of collegial learning and feedback. However, they reported that their municipalities lacked basic conditions for making the whole concept work in such a short time. The ELR is overall perceived as useful, but experiences also make complex difficulties visible regarding integrated, coordinated rehabilitation and organizational readiness. Based on findings, a recommendation on basic prerequisites will be added to the ELR guidance for leadership and management. CLINICAL TRIAL REGISTRATION [ClinicalTrials.gov, 24 September 2021], identifier [NCT05056415].
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Affiliation(s)
- Maria Lindström
- Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
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19
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Klevan T, Jonassen R, Topor A, Borg M. Mutual learning: exploring collaboration, knowledge and roles in the development of recovery-oriented services. A hermeneutic-phenomenological study. Int J Qual Stud Health Well-being 2021; 16:2001898. [PMID: 34802400 PMCID: PMC8635568 DOI: 10.1080/17482631.2021.2001898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose The concept of recovery is commonly described as multifaceted and contested in the field of mental health and substance abuse. The aim of this study is to explore how understandings of recovery and recovery orientation of services are developed through daily practices and collaboration between service users and professionals. Methods Eight pairs of participants were interviewed together, in accordance with the dyadic interview method. The dyads/pairs consisted of service users and professional helpers. A collaborative hermeneutic-phenomenological analysis was used to analyse data. Results Data were analysed into three overarching and entangled themes, exploring how recovery-oriented collaboration and knowledge encompasses (a) recovery as relational processes. These processes are entangled with (b) recovery as situated in time and place. Furthermore, relational processes and dimensions of time and place are situated in and supported or hindered by (c) recovery orientation as part of the municipal policies, understood as the regulations, frameworks and decisions guiding mental health and substance abuse services in the municipality. Conclusions The further development of recovery-oriented services should focus on facilitating open-ended and flexible ways of developing practices and relationships. This involves recognizing how relationships contribute to the development of knowledge and practices.
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Affiliation(s)
- Trude Klevan
- Center for Mental Health and Substance Abuse, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Reidun Jonassen
- Center for Mental Health and Substance Abuse, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Alain Topor
- Department of Psychosocial Health, University of Agder, Grimstad, Norway
| | - Marit Borg
- Center for Mental Health and Substance Abuse, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
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20
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Pérez-Corrales J, Güeita-Rodríguez J, Huertas-Hoyas E, García-Bravo C, Marconnot R, Jiménez-Antona C, Velarde-García JF, Palacios-Ceña D. The Meaning of Volunteering among People with Severe Mental Disorders: A Phenomenological Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12232. [PMID: 34831988 PMCID: PMC8621690 DOI: 10.3390/ijerph182212232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/16/2021] [Accepted: 11/18/2021] [Indexed: 11/17/2022]
Abstract
This study aimed to describe the perspectives of people with severe mental disorders who volunteer regarding the relationship between volunteering and work, from the framework of personal recovery. A qualitative phenomenological study was undertaken. Purposive sampling was conducted on people with severe mental disorders who participated in volunteering. In-depth unstructured and semi-structured interviews were used, during which researchers took handwritten field notes. An inductive thematic analysis was applied. Twenty-three participants with severe mental disorders were included (16 men and 7 women) with a mean age of 47 years. Three themes emerged: (a) the relationship between volunteering and working; (b) thinking about a possible future job; and (c) disclosing a mental health condition. Volunteering is perceived as a substitute to working, although not all participants feel able to work, and they do not always disclose that they suffer from a mental health condition.
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Affiliation(s)
- Jorge Pérez-Corrales
- Research Group of Humanities and Qualitative Research in Health Science (Hum&QRinHS), Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos Avenida Atenas s/n, 28922 Alcorcón, Spain; (J.P.-C.); (R.M.); (C.J.-A.); (D.P.-C.)
| | - Javier Güeita-Rodríguez
- Research Group of Humanities and Qualitative Research in Health Science (Hum&QRinHS), Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos Avenida Atenas s/n, 28922 Alcorcón, Spain; (J.P.-C.); (R.M.); (C.J.-A.); (D.P.-C.)
| | - Elisabet Huertas-Hoyas
- Research Group in Evaluation and Assessment of Capacity, Functionality and Disability (TO+IDI), Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Avenida Atenas s/n, 28922 Alcorcón, Spain; (E.H.-H.); (C.G.-B.)
| | - Cristina García-Bravo
- Research Group in Evaluation and Assessment of Capacity, Functionality and Disability (TO+IDI), Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Avenida Atenas s/n, 28922 Alcorcón, Spain; (E.H.-H.); (C.G.-B.)
| | - Romain Marconnot
- Research Group of Humanities and Qualitative Research in Health Science (Hum&QRinHS), Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos Avenida Atenas s/n, 28922 Alcorcón, Spain; (J.P.-C.); (R.M.); (C.J.-A.); (D.P.-C.)
| | - Carmen Jiménez-Antona
- Research Group of Humanities and Qualitative Research in Health Science (Hum&QRinHS), Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos Avenida Atenas s/n, 28922 Alcorcón, Spain; (J.P.-C.); (R.M.); (C.J.-A.); (D.P.-C.)
| | - Juan Francisco Velarde-García
- Department of Nursing, Instituto de Investigación del Hospital Gregorio Marañón (IiSGM), Red Cross College, Universidad Autónoma de Madrid, Calle Reina Victoria 28, 28003 Madrid, Spain;
| | - Domingo Palacios-Ceña
- Research Group of Humanities and Qualitative Research in Health Science (Hum&QRinHS), Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos Avenida Atenas s/n, 28922 Alcorcón, Spain; (J.P.-C.); (R.M.); (C.J.-A.); (D.P.-C.)
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21
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Rocamora-Montenegro M, Compañ-Gabucio LM, Garcia de la Hera M. Occupational therapy interventions for adults with severe mental illness: a scoping review. BMJ Open 2021; 11:e047467. [PMID: 34716157 PMCID: PMC8559113 DOI: 10.1136/bmjopen-2020-047467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE To identify the occupational therapy (OT) interventions in adults with severe mental illness (SMI) most investigated in intervention studies and to describe their characteristics. DESIGN Scoping review. DATA SOURCES On 17 January 2020, we searched the following electronic databases: MEDLINE, Scopus, Web of Science and EMBASE. We also performed a manual search of TESEO doctoral thesis database and of the journals indexed in the first quartile of OT according to the SCImago Journal Rank. We updated our search on 10 March 2021, performing a complementary search on ProQuest database and repeating the search in all sources. The terms included in the search strategy were: schizophrenia, schizotypal personality, delusional, schizoaffective, psychotic, bipolar, major depression, obsessive-compulsive, severe mental, OT and intervention. STUDY SELECTION The study screening was peer-reviewed. Inclusion criteria were: (1) OT intervention studies in SMI: experimental, randomised, non-randomised and pilot/exploratory studies; (2) adult population with SMI: schizophrenia, schizotypal personality disorder, delusional disorder, obsessive-compulsive disorder, schizoaffective disorder, psychotic disorder, bipolar disorder, major depressive disorder; (3) OT identified as a discipline involved in the intervention; (4) English or Spanish language and (5) studies with full text available. RESULTS Thirty-five studies met the inclusion criteria. OT interventions were classified in psychosocial, psychoeducational, cognitive and exercise interventions. The most used OT intervention was psychosocial intervention. CONCLUSION Psychosocial intervention was the most investigated OT intervention in SMI, followed by psychoeducational, cognitive and exercise interventions. These interventions are usually group interventions in patients with schizophrenia, performed by a multidisciplinary team (in which an occupational therapist collaborates), with 2-3 weekly 60 min sessions and a duration of 3-6 months.
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Affiliation(s)
- María Rocamora-Montenegro
- Department of Public Health History of Science and Gynaecology, Universidad Miguel Hernandez de Elche, Sant Joan d'Alacant, Alicante, Spain
| | - Laura-María Compañ-Gabucio
- Department of Public Health History of Science and Gynaecology, Universidad Miguel Hernandez de Elche, Sant Joan d'Alacant, Alicante, Spain
- ISABIAL, Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante, Comunidad Valenciana, Spain
| | - Manuela Garcia de la Hera
- Department of Public Health History of Science and Gynaecology, Universidad Miguel Hernandez de Elche, Sant Joan d'Alacant, Alicante, Spain
- ISABIAL, Instituto de Investigación Sanitaria y Biomédica de Alicante, Alicante, Comunidad Valenciana, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Kinn LG, Costa M, Voll I, Austrheim G, Aas RW, Davidson L. "Navigating Between Unpredictable Icebergs": A Meta-Ethnographic Study of Employment Specialists' Contributions in Providing Job Support for People with Mental Illness. JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:512-531. [PMID: 33200260 DOI: 10.1007/s10926-020-09943-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/03/2020] [Indexed: 06/11/2023]
Abstract
Purpose To explore and synthesize the views of Supported Employment clients, employment specialists and their supervisors on the core contributions of employment specialists to job support within the mental health field. Methods We systematically searched four databases with no time limitations and identified 16 qualitative studies published between 2006 and 2018 to be included in this meta-ethnographic study. Results The overarching metaphor of "Navigating an Unpredictable Iceberg-laden Sea" (a workplace) and seven themes were revealed: (1) "It's you and me looking," which represented the relationship between the client and ES, and (2) taking job seekers' ambitions and needs seriously, (3) mapping the route, (4) exploring the hidden, (5) being on tap, (6) avoiding crashes, and (7) bridging, which embodied the work of employments specialists. Conclusion. Our iceberg metaphor illustrates the importance of employment specialists being competent in addressing clients' work performance difficulties related not only to the individual's illness, age, gender, and cultural-related challenges, but also to psychosocial, behavioral, and environmental workplace factors. Given the effects of the specific characteristics of the working alliance developed in supported employment, we suggest that employment specialists' training and supervision be enriched by paying more attention to these important relational processes.
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Affiliation(s)
- Liv Grethe Kinn
- Department of Welfare and Participation at Western Norway University of Applied Sciences, Inndalsveien 28, 5063, Bergen, Norway.
| | - Mark Costa
- Yale Program for Recovery and Community Health, Yale School of Medicine, 319 Peck Street, New Haven, CT, 06513, USA
| | - Ingrid Voll
- Department of Welfare and Participation at Western Norway University of Applied Sciences, Inndalsveien 28, 5063, Bergen, Norway
| | - Gunhild Austrheim
- Western Norway University of Applied Sciences, Inndalsveien 28, 5063, Bergen, Norway
| | - Randi W Aas
- University of Stavanger, Kjell Arholms gate 41, 4021, Stavanger, Norway
- Oslo Metropolitan University, Oslo, Norway
| | - Larry Davidson
- Yale Program for Recovery and Community Health, Yale School of Medicine, 319 Peck Street, New Haven, CT, 06513, USA
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Doroud N, Fossey E, Fortune T, Brophy L, Mountford L. A journey of living well: a participatory photovoice study exploring recovery and everyday activities with people experiencing mental illness. J Ment Health 2021; 31:246-254. [PMID: 34269637 DOI: 10.1080/09638237.2021.1952950] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND AIM Engagement in everyday activities has been identified as an important element in personal recovery from the experience of mental illness and a key priority for service-users. This study explored the role of everyday activities in recovery. METHOD This study used a photovoice participatory research. Twenty-one participants experiencing mental illness were recruited from a community-managed mental health service in Melbourne, Australia. Data collection included individual interviews and photovoice courses. The courses included group discussions and required participants to take photographs about their everyday activities that support recovery. A lived experience co-facilitator contributed to development and delivery of the course. The interviews and group discussions were transcribed verbatim and analysed using constant comparative methods. RESULTS Recovery as a "journey of living well" was identified as the central theme that encompasses three interlinked categories: (1) living a life on hold; (2) choosing to recover; and (3) learning and navigating strategies. CONCLUSIONS The findings suggest that recovery involves a range of experiences embedded in people's everyday lives. Recovery-oriented practice should provide opportunities for engagement in meaningful activities, to help consumers identify their potential and strategies to live well, and to adopt co-production at all levels.
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Affiliation(s)
- Nastaran Doroud
- Occupational Therapy Discipline, Rural Department of Allied Health, La Trobe University, Victoria, Australia
| | - Ellie Fossey
- Department of Occupational Therapy, School of Primary and Allied Health Care, Monash University, Victoria, Australia.,Living with Disability Research Centre, La Trobe University, Victoria, Australia
| | - Tracy Fortune
- Department of Occupational Therapy, Social Work and Social Policy, School of Allied Health, Human Services and Sport, La Trobe University, Victoria, Australia
| | - Lisa Brophy
- Department of Occupational Therapy, Social Work and Social Policy, School of Allied Health, Human Services and Sport, La Trobe University, Victoria, Australia.,Centre for Mental Health, Melbourne School of Population and Global health, The University of Melbourne, Victoria, Australia
| | - Louise Mountford
- Living with Disability Research Centre, La Trobe University, Victoria, Australia.,Possability, Victoria, Australia
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24
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Lama TC, Fu Y, Davis JA. Exploring the ideal practice for occupational therapists on assertive community treatment teams. Br J Occup Ther 2021. [DOI: 10.1177/03080226211026558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction Canadian occupational therapists are employed as case managers on assertive community treatment (ACT) teams to support community living for individuals with severe and persistent mental illnesses. In this position, occupational therapists act primarily as generalists, typically attending appointments with clients, supervising medication adherence, supporting basic living needs, and managing client crises. Occupational therapists may also provide psychotherapy and coping skill groups, as well as profession-specific practices, such as skills training. Exploring how ACT occupational therapists describe their perceived ideal practice may support transformation in long-standing, occupational therapy practices on ACT teams. Method This qualitative, interpretive description study involved 11 Canadian ACT team occupational therapists in one individual, semi-structured in-depth interview using an interview guide containing open-ended questions. Interview transcripts were analyzed to identify themes pertaining to therapists’ descriptions of their perceived ideal occupational therapy practice on ACT teams. Results Three themes emerged: (a) Engaging in practice “with intention”; (b) Finding the space for occupational therapy practice; and (c) Supporting clients in their recovery to find their best occupational self. Conclusions The findings highlight practice possibilities for occupational therapist working on ACT teams and provide a foundation for advocating for better use of specific occupational therapy practices within community mental health settings.
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Affiliation(s)
- Tenzin C Lama
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Yumeng Fu
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Jane A Davis
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
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25
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Nesbitt AE, Collins KJ, Nalder E, Sabiston CM. Occupational outcomes of a physical activity intervention for post-secondary student mental health. The Canadian Journal of Occupational Therapy 2021; 88:254-265. [PMID: 34132119 DOI: 10.1177/00084174211021708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND. Physical activity (PA) is a therapeutic approach to address post-secondary student mental health, yet the effect of PA on occupational outcomes has been understudied among students. PURPOSE. This study (1) identified and described occupational performance issues (OPIs) among post-secondary students seeking mental health support and (2) assessed pre- and post-intervention differences in occupational performance and performance satisfaction. METHOD. Using a single group pre-test post-test pilot study design, participants (N = 20) completed a 6-week, 1-hour PA intervention. The Canadian Occupational Performance Measure was administered pre- and post-intervention. FINDINGS. The most commonly reported OPIs included academics, PA, and sleep hygiene. There were significant improvements in participants' occupational performance (mean change: 2.7, p < .001; dz = 2.28) and performance satisfaction (mean change: 3.7, p < .001; dz = 3.04). IMPLICATIONS. Results provide an initial demonstration of the benefits of PA for occupational outcomes within a post-secondary mental health context.
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Tchernegovski P, Braithwaite E, Stewart SE. Perspectives of recovery amongst provisional psychologists completing postgraduate training. AUSTRALIAN PSYCHOLOGIST 2021. [DOI: 10.1080/00050067.2021.1928475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Joyce A, Elmes A, Campbell P, Moussa B, Suchowerska R, Barraket J, Carey G. The health and well-being impacts of a work integration social enterprise from a systems perspective. Health Promot Int 2021; 37:6279253. [PMID: 34015101 DOI: 10.1093/heapro/daab052] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Recent research has drawn upon the social determinants of health (SDH) framework to attempt to systematize the relationship between social enterprise and health. In this article, we adopt a realist evaluation approach to conceptualize social enterprises, and work integration social enterprises in particular, as 'complex interventions' that necessarily produce differential health outcomes for their beneficiaries, communities and staff. Drawing upon the findings from four social enterprises involving a range of methods including 93 semi-structured interviews with employees, managers and enterprise partners, together with participant observation, we demonstrate that these health outcomes are influenced by a limitless mix of complex and dynamic interactions between systems, settings, spaces, relationships and organizational and personal factors that cannot be distilled by questions of causality and attribution found in controlled trial designs. Given the increased policy focus on the potential of social enterprises to affect the SDH, this article seeks to respond to evidence gaps about the mechanisms and contexts through which social enterprises promote or constrain health outcomes, and thereby provide greater clarity about how research evidence can be used to support the social enterprise sector and policy development more broadly.
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Affiliation(s)
- Andrew Joyce
- Centre for Social Impact, Swinburne University of Technology, Hawthorn, Australia
| | - Aurora Elmes
- Centre for Social Impact, Swinburne University of Technology, Hawthorn, Australia
| | - Perri Campbell
- Centre for Social Impact, Swinburne University of Technology, Hawthorn, Australia
| | - Batool Moussa
- Centre for Social Impact, Swinburne University of Technology, Hawthorn, Australia
| | | | - Jo Barraket
- Centre for Social Impact, Swinburne University of Technology, Hawthorn, Australia
| | - Gemma Carey
- Centre for Social Impact, University of New South Wales, Sydney, Australia
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Nesse L, Aamodt G, Gonzalez MT, Rowe M, Raanaas RK. The role of occupational meaningfulness and citizenship as mediators between occupational status and recovery: a cross-sectional study among residents with co-occurring problems. ADVANCES IN DUAL DIAGNOSIS 2021. [DOI: 10.1108/add-08-2020-0018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Engagement in meaningful occupations and being included as full citizens of the community, is essential in everyday life, and may be of considerable relevance for recovery and quality of life. However, persons with co-occurring substance use and mental health problems experience extensive obstacles to engagement in occupations and citizenship. The relationship between objective measures of occupational status and subjective experiences of occupational meaningfulness, citizenship and recovery, is scarcely researched in the context of co-occurring problems. As such, the purpose of this study is to examine associations between occupational status, occupational meaningfulness, citizenship and recovery and quality of life and to examine the roles of occupational meaningfulness and citizenship as possible mediators between occupational status and recovery and quality of life.
Design/methodology/approach
The study used a cross-sectional design with a sample of 104 residents at supported housing sites across six Norwegian cities.
Findings
Linear regression analyzes indicated that occupational status was significantly associated with the citizenship domains caring for others and community participation and with the quality of life measure positive affect. Occupational meaningfulness and citizenship were significantly associated with different domains of recovery and quality of life. Furthermore, mediation analyzes showed that the relationship between occupational status and recovery and quality of life was mediated by caring for others and community participation.
Originality/value
The results suggest that emphasizing opportunities for occupational meaningfulness and citizenship in practice may have positive implications for recovery among persons with co-occurring problems.
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von Peter S, Göppert L, Ziegenhagen J, Beeker T, Glück R, Groth B, Groß U, Reinholdt A, Boerma R, Heißler M, Habicht J, Schwarz J. Supported Employment, Participation at Work, and Peer Support: A Qualitative, Participatory Case Study Report of the Geesthacht Model. Front Psychiatry 2021; 12:634080. [PMID: 33967854 PMCID: PMC8102772 DOI: 10.3389/fpsyt.2021.634080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 03/23/2021] [Indexed: 11/19/2022] Open
Abstract
Background: For people who have experienced mental health crises or psychosocial disabilities, it is considerably more difficult to receive support to participate in work on an equal basis with others. In the town of Geesthacht, in Northern Germany, an integrative care network was implemented that allows for acute psychiatric treatment as well as participation in work and activities. This paper aims to explore the principles, advantages, and challenges of this innovative project. Methodology: Within the context of a participatory and collaborative process evaluation of a prospective controlled cohort study (PsychCare), researchers with and without experiential expertise conducted expert interviews and focus groups to evaluate the experiences of 37 employees, with and without lived experience, from various institutions associated with this care network. The data was analyzed using qualitative content analysis. Results: It was the change from financial compensation paid on a daily basis to a global treatment budget that allowed for a significant reduction of hospital beds in Geesthacht and freed up resources to implement a complex care network. Since then, various possibilities for participation, work, and activities for former service users, some of which are compensated financially, have been made available. These developments now allow for a less bureaucratic and often smooth transition from being a service user to involvement in participatory activities in the role of a peer, which is frequently perceived to be empowering and beneficial by participants with lived experience. At the same time, this care model has led to multiple role conflicts and different challenges for all parties involved. Conclusion: This innovative project in Geesthacht demonstrates the multifaceted potential of a global treatment budget system in the field of mental health care. To address certain downsides of the Geesthacht model, further development is necessary.
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Affiliation(s)
- Sebastian von Peter
- Department of Psychiatry and Psychotherapy, Brandenburg Medical School, Immanuel Albertinen Hospital Rüdersdorf, Rüdersdorf, Germany
| | - Lena Göppert
- Department of Psychiatry and Psychotherapy, Brandenburg Medical School, Immanuel Albertinen Hospital Rüdersdorf, Rüdersdorf, Germany
| | - Jenny Ziegenhagen
- Department of Psychiatry and Psychotherapy, Brandenburg Medical School, Immanuel Albertinen Hospital Rüdersdorf, Rüdersdorf, Germany
- ExPEERienced – Experience With Mental Health Crises – Registered Non-Profit Organization, Berlin, Germany
| | - Timo Beeker
- Department of Psychiatry and Psychotherapy, Brandenburg Medical School, Immanuel Albertinen Hospital Rüdersdorf, Rüdersdorf, Germany
| | - Rosa Glück
- Department of Psychiatry and Psychotherapy, Brandenburg Medical School, Immanuel Albertinen Hospital Rüdersdorf, Rüdersdorf, Germany
| | - Birte Groth
- Department of Psychiatry, Psychotherapy and Psychosomatics, Johanniter Hospital Geesthacht, Geesthacht, Germany
| | - Uwe Groß
- Department of Psychiatry, Psychotherapy and Psychosomatics, Johanniter Hospital Geesthacht, Geesthacht, Germany
| | - Arne Reinholdt
- Department of Psychiatry, Psychotherapy and Psychosomatics, Johanniter Hospital Geesthacht, Geesthacht, Germany
| | - Robin Boerma
- Department of Psychiatry, Psychotherapy and Psychosomatics, Johanniter Hospital Geesthacht, Geesthacht, Germany
| | - Matthias Heißler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Johanniter Hospital Geesthacht, Geesthacht, Germany
| | - Juri Habicht
- Department of Psychiatry and Psychotherapy, Brandenburg Medical School, Immanuel Albertinen Hospital Rüdersdorf, Rüdersdorf, Germany
| | - Julian Schwarz
- Department of Psychiatry and Psychotherapy, Brandenburg Medical School, Immanuel Albertinen Hospital Rüdersdorf, Rüdersdorf, Germany
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Identifying occupational therapy outcome measures supportive of recovery-orientated mental health services in Ireland. IRISH JOURNAL OF OCCUPATIONAL THERAPY 2021. [DOI: 10.1108/ijot-01-2020-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose
No occupational therapy outcome measures have been designed specifically for recovery-orientated services.This paper aims to identify occupational therapy outcome measures relevant to mental health practice and assess them against recovery principles adopted by Irish Mental Health Services.
Design/methodology/approach
A narrative review methodology was used to appraise outcome measures against CHIME recovery principles.
Findings
A systematic search across 13 databases identified eight well-established outcome measures commonly used within occupational therapy mental health literature. The included outcome measures were appraised using a recovery alignment tool.
Practical implications
All outcome measures connected to some recovery processes. Those using semi-structured interview formats and notably the Canadian Occupational Performance Measure (COPM) had the strongest alignment to recovery processes.
Originality/value
This is the first known review which provides some validation that the included outcome measures support recovery processes, yet the measures rely heavily on therapist’s skills for processes to be facilitated. It recommends that ways to better support the process of partnership in occupational therapy mental health outcome measures be explored and further research be undertaken.
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Gamieldien F, Galvaan R, Myers B, Syed Z, Sorsdahl K. Exploration of recovery of people living with severe mental illness (SMI) in low/middle-income countries (LMICs): a scoping review. BMJ Open 2021; 11:e045005. [PMID: 33762242 PMCID: PMC7993175 DOI: 10.1136/bmjopen-2020-045005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 02/02/2021] [Accepted: 02/24/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To examine the literature on how recovery of people with severe mental illness (SMI) is conceptualised in low/middle-income countries (LMICs), and in particular what factors are thought to facilitate recovery. DESIGN Scoping review. DATA SOURCES AND ELIGIBILITY We searched 14 electronic databases, hand searched citations and consulted with experts during the period May-December 2019. Eligible studies were independently screened for inclusion and exclusion by two reviewers. Unresolved discrepancies were referred to a third reviewer. DATA EXTRACTION AND SYNTHESIS All bibliographical data and study characteristics were extracted using a data charting form. Selected studies were analysed through a thematic analysis emerging from extracted data. RESULTS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram offers a summary of the results: 4201 titles, 1530 abstracts and 109 full-text articles were screened. Ten articles were selected for inclusion: two from Turkey, two from India, and one each from China, Swaziland, Indonesia, Egypt, South Africa and Vietnam. Although most studies used qualitative methods, data collection and sampling methods were heterogeneous. One study reported on service provider perspectives while the rest provided perspectives from a combination of service users and caregivers. Three themes emerged from the data analysis. First, studies frame recovery as a personal journey occurring along a continuum. Second, there was an emphasis on social relationships as a facilitator of recovery. Third, spirituality emerged as both a facilitator and an indicator of recovery. These themes were not mutually exclusive and some overlap exists. CONCLUSION Although there were commonalities with how high-income countries describe recovery, we also found differences in conceptualisation. These differences in how recovery was understood reflect the importance of framing the personal recovery concept in relation to local needs and contextual issues found in LMICs. This review highlighted the current sparse evidence base and the need to better understand recovery from SMI in LMICs.
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Affiliation(s)
- Fadia Gamieldien
- Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town Faculty of Health Sciences, Rondebosch, Western Cape, South Africa
- Division of Occupational Therapy, Department of Health and Rehabilitation Sciences, University of Cape Town Faculty of Health Sciences, Observatory, Western Cape, South Africa
- Inclusive Practices Africa Research Group, University of Cape Town, Cape Town, South Africa
| | - Roshan Galvaan
- Division of Occupational Therapy, Department of Health and Rehabilitation Sciences, University of Cape Town Faculty of Health Sciences, Observatory, Western Cape, South Africa
- Inclusive Practices Africa Research Group, University of Cape Town, Cape Town, South Africa
| | - Bronwyn Myers
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, Western Cape, South Africa
- Division of Addiction Psychiatry, Department of Psychiatry and Mental Health, University of Cape Town Faculty of Health Sciences, Observatory, Western Cape, South Africa
| | - Zarina Syed
- Division of Occupational Therapy, Department of Health and Rehabilitation Sciences, University of Cape Town Faculty of Health Sciences, Observatory, Western Cape, South Africa
| | - Katherine Sorsdahl
- Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town Faculty of Health Sciences, Rondebosch, Western Cape, South Africa
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Nuño L, Guilera G, Bell M, Rojo E, Gómez-Benito J, Calderón C, Barrios M. Occupational Therapists’ Perspective on the International Classification of Functioning, Disability and Health Core Sets (ICF–CS) for Schizophrenia. Am J Occup Ther 2021; 75:7502205060p1-7502205060p10. [PMID: 33657348 DOI: 10.5014/ajot.2021.041509] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
Importance: The International Classification of Functioning, Disability and Health (ICF) Core Sets (CSs) for schizophrenia are sets of ICF categories that are relevant specifically to the functioning and disability of people with schizophrenia.
Objective: To identify the problems occupational therapists commonly encounter when treating people with schizophrenia and to validate the ICF–CSs for schizophrenia from their perspective.
Design: Three-round Delphi study using online surveys distributed to occupational therapists worldwide. Participants were asked which problems with functioning they considered most relevant when treating people with schizophrenia.
Participants: Occupational therapists experienced in the treatment of people with schizophrenia.
Measures: Responses were linked to the ICF categories by two trained health professionals, and a statistical measure of agreement and κ coefficient were calculated.
Results: Ninety-two occupational therapists from 29 countries in all six World Health Organization regions named 2,527 meaningful concepts. After the linking process, 121 ICF categories and 31 Personal Factors were presented to the expert panel, who reached consensus (agreement of ≥75%) on 97 ICF categories and 27 Personal Factors. Consensus was reached on the 25 categories in the Brief ICF–CS for schizophrenia and 89 of the 97 categories in the Comprehensive ICF–CS for schizophrenia.
Conclusions and Relevance: The ICF Core Sets for schizophrenia were validated from the perspective of occupational therapists and are potentially useful tools for clinical practice because they cover a wide variety of problems that occupational therapists deal with in interventions with people with schizophrenia.
What This Article Adds: The ICF–CSs for schizophrenia are useful guides for describing and classifying functioning, disability, and health to aid occupational therapy intervention with people with schizophrenia. Occupational therapists are essential in the rehabilitation of this client population, and their perspective has contributed to the development and enrichment of the ICF–CSs for schizophrenia.
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Affiliation(s)
- Laura Nuño
- Laura Nuño, PhD, is Clinical Psychologist, Clinical Institute of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain;
| | - Georgina Guilera
- Georgina Guilera, PhD, is Professor, Institute of Neurosciences and Department of Social Psychology and Quantitative Psychology, University of Barcelona, Barcelona, Spain
| | - Morris Bell
- Morris Bell, PhD, is Professor, Connecticut Mental Health Center, Yale School of Medicine, New Haven, CT
| | - Emilio Rojo
- Emilio Rojo, MD, is Medical Director, Hospital Benito Menni Complex Assistencial en Salut Mental, Sisters Hospitallers, Sant Boi de Llobregat, Spain, and Professor, Department of Psychiatry, International University of Catalonia, Barcelona, Spain
| | - Juana Gómez-Benito
- Juana Gómez-Benito, PhD, is Professor, Institute of Neurosciences and Department of Social Psychology and Quantitative Psychology, University of Barcelona, Barcelona, Spain
| | - Caterina Calderón
- Caterina Calderón, PhD, is Associate Professor, Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain
| | - Maite Barrios
- Maite Barrios, PhD, is Associate Professor, Institute of Neurosciences and Department of Social Psychology and Quantitative Psychology, University of Barcelona, Barcelona, Spain
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Rees EF, Ennals P, Fossey E. Implementing an Action Over Inertia Group Program in Community Residential Rehabilitation Services: Group Participant and Facilitator Perspectives. Front Psychiatry 2021; 12:624803. [PMID: 33603690 PMCID: PMC7884341 DOI: 10.3389/fpsyt.2021.624803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 01/11/2021] [Indexed: 12/03/2022] Open
Abstract
Introduction: A time-use focused intervention, Action Over Inertia (AOI) designed to address restricted activity patterns and support recovery, was adapted for use in Australian community residential mental health services. Method: Qualitative case study research explored the use of AOI groups across three Community Care Units from the perspectives of group participants with enduring mental illness and group facilitators. Fifteen interviews were conducted: five group participants were interviewed twice 4 weeks apart, and five group facilitators on completion of the group intervention. Interview data were analyzed thematically using constant comparative methods. Findings: Two overarching themes, "Making Change" and "Facilitating Change" were identified. Efforts to make change in their lives were supported by participants recognising the value of personally meaningful activities for well-being and of activity experiences that fostered hope and recovery, whereas a sense of "stuckness," time for activities and life events could disrupt "getting me going." For the facilitators, facilitating change involved recognizing inertia as a challenge; getting people going; and looking at how AOI intervention works to impact inertia. Conclusion: AOI in a group format supports participants to identify barriers to more active living; to appreciate how time-use and well-being interrelate; and to reframe and take steps to overcome inertia. Further research should evaluate AOI groups as a means of providing individualized support for activity re-engagement as part of recovery oriented mental health rehabilitation.
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Affiliation(s)
- Erin F Rees
- The Royal Melbourne Hospital - North Western Mental Health, Melbourne, VIC, Australia
| | - Priscilla Ennals
- Neami National, Preston, VIC, Australia.,Department of Occupational Therapy, Social Work and Social Policy, La Trobe University, Melbourne, VIC, Australia.,Department of Occupational Therapy, Monash University, Melbourne, VIC, Australia
| | - Ellie Fossey
- Department of Occupational Therapy, Monash University, Melbourne, VIC, Australia.,Living With Disability Research Centre, La Trobe University, Melbourne, VIC, Australia
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Whybird G, Nott Z, Savage E, Korman N, Suetani S, Hielscher E, Vilic G, Tillston S, Patterson S, Chapman J. Promoting quality of life and recovery in adults with mental health issues using exercise and nutrition intervention. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2020. [DOI: 10.1080/00207411.2020.1854023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
| | - Zoie Nott
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland
- The University of Queensland, School of Psychology, Brisbane, Queensland
| | - Emma Savage
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland
- The University of Queensland, School of Psychology, Brisbane, Queensland
| | - Nicole Korman
- Metro South Addictions and Mental Health Service, Metro South Health, Brisbane, Queensland
- The University of Queensland, School of Medicine, Brisbane, Queensland
| | - Shuichi Suetani
- Metro South Addictions and Mental Health Service, Metro South Health, Brisbane, Queensland
- The University of Queensland, School of Medicine, Brisbane, Queensland
| | - Emily Hielscher
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland
- The University of Queensland, School of Medicine, Brisbane, Queensland
| | - Gabrielle Vilic
- Metro South Addictions and Mental Health Service, Metro South Health, Brisbane, Queensland
| | - Stephen Tillston
- Queensland Police-Citizens Youth Welfare Association, Brisbane, Queensland
| | - Sue Patterson
- Metro North Mental Health Service, Metro North Health, Brisbane, Queensland
| | - Justin Chapman
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland
- Metro South Addictions and Mental Health Service, Metro South Health, Brisbane, Queensland
- Queensland Police-Citizens Youth Welfare Association, Brisbane, Queensland
- The University of Queensland, School of Human Movement and Nutrition Sciences, Brisbane, Queensland
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Argentzell E, Bäckström M, Lund K, Eklund M. Exploring mediators of the recovery process over time among mental health service users, using a mixed model regression analysis based on cluster RCT data. BMC Psychiatry 2020; 20:520. [PMID: 33126873 PMCID: PMC7602343 DOI: 10.1186/s12888-020-02924-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 10/19/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Personal recovery is associated with many significant health-related factors, but studies exploring associations between activity factors and personal recovery among service users are scarce. The aims of this study were hence to; 1) investigate if various aspects of activity may mediate change in recovery while also acknowledging clinical, sociodemographic and well-being factors; 2) explore the effects of two activity-based interventions, Balancing Everyday Life (BEL) or standard occupational therapy (SOT), on personal recovery among service users. METHODS Two-hundred-and-twenty-six service users were included in a cluster RCT, 133 from BEL units and 93 from SOT units. Participants commonly had a diagnosis of mood disorder and the mean age was 40. Instruments used targeted activity, mastery and functioning. A mixed-model regression analysis was employed. RESULTS The model tested was whether selected variables could be used to mediate the change in recovery from the start to a six-month follow-up after intervention. Participants' personal recovery increased after treatment and increased further at the follow-up. The general level of recovery was negatively related to a diagnosis of depression/anxiety, both before and after treatment, but depressed/anxious service users still increased their recovery. There were no significant relations between recovery and sex or age. The interactions between change in recovery and changes in depression/anxiety, satisfaction with activities, sex, and age were all non-significant. All possible treatment mediators included were related to change in recovery, the strongest being occupational engagement and mastery, followed by activity satisfaction and symptoms. Mediation was shown by the decrease in the effect of the time factor (from intervention start to completion) when the covariates were introduced. In all cases the time variable was still significant. When testing a model with all variables simultaneously as covariates, occupational engagement and mastery were strongly significant. There was no difference between interventions regarding recovery improvement. CONCLUSION The treatments were equally beneficial and were effective regardless of gender, age and diagnosis. Those who gained most from the treatment also gained in feelings of mastery and activity engagement. Activity engagement also moderated the level of recovery. To enhance recovery, interventions should facilitate meaningful activities and gaining control in life. TRIAL REGISTRATION The study was registered with ClinicalTrials.gov . Reg. No. NCT02619318 . Retrospectively registered: December 2, 2015.
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Affiliation(s)
- Elisabeth Argentzell
- Lund University, Department of Health Sciences, the Mental Health, Activity and Participation (MAP) group, Box 157, 221 00, Lund, Sweden.
| | - Martin Bäckström
- grid.4514.40000 0001 0930 2361Lund University, Department of Psychology, Box 213, 221 00 Lund, Sweden
| | - Kristine Lund
- grid.4514.40000 0001 0930 2361Lund University, Department of Health Sciences, the Mental Health, Activity and Participation (MAP) group, Box 157, 221 00 Lund, Sweden
| | - Mona Eklund
- grid.4514.40000 0001 0930 2361Lund University, Department of Health Sciences, the Mental Health, Activity and Participation (MAP) group, Box 157, 221 00 Lund, Sweden
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Mental health consumers’ perspectives on using an occupation-focused assessment to initiate change in everyday activities. Br J Occup Ther 2020. [DOI: 10.1177/0308022620954340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction Engagement in meaningful activities is central to recovery for people with mental health conditions. The aim of this study was to examine the utility of an occupation-focused assessment, the Daily Experiences of Pleasure, Productivity, and Restoration Profile, as a means to guide engagement in meaningful activity. Methods Eight consumers who were receiving services from a community-based behavioural health centre utilized the Profile to set and work towards self-identified goals. Data derived from audiotaped sessions, notes, and a focus group were analysed using an iterative content analysis process. Results Three themes emerged: completion of the Profile was ‘burdensome, but right on’, moving from insights gained to choosing and working towards a goal required guidance from the therapist, and insights gained from the Profile supported some changes in actions and perspectives. Conclusion The findings support preliminary utility of the Daily Experiences of Pleasure, Productivity, and Restoration Profile to guide engagement in meaningful activity among people living with mental health conditions. Moreover, the support and guidance of the occupational therapist is critical. Continued examination of the use of the Profile is warranted to help support occupational therapy’s role in promoting recovery for people with mental health conditions through meaningful activities.
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Bjørkedal STB, Bejerholm U, Eplov LF, Møller T. Meaningful Activities and Recovery (MA&R): the effect of a novel rehabilitation intervention among persons with psychiatric disabilities on activity engagement-study protocol for a randomized controlled trial. Trials 2020; 21:789. [PMID: 32928298 PMCID: PMC7491082 DOI: 10.1186/s13063-020-04722-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 09/03/2020] [Indexed: 01/06/2023] Open
Abstract
Background Engagement in activities meaningful to the individual may support the process of recovery in those with mental illness. Persons with psychiatric disabilities may reduce their engagement in meaningful activities to various degrees with possible fluctuations over time. We hypothesized that activity engagement can be altered when opportunities and support are offered at an individual and a group peer-based level. Evidence is lacking regarding mental health interventions that enable engagement in meaningful activities, and powered effect studies are warranted. Methods We propose an 8-month combined individual and group peer-based intervention, Meaningful Activities and Recovery (MA&R), and a study protocol for a multicentre two-armed parallel randomized controlled trial (RCT). The trial investigates the effects of MA&R in community mental health centres in Copenhagen and municipality services in Denmark. The trial will comprise 128 participants with psychiatric disabilities who will be randomized to one of two groups: (1) MA&R in addition to standard mental healthcare or (2) standard mental healthcare alone. The primary outcome is self-reported activity engagement, measured by Profiles of Engagement in People with Severe Mental Illness. Secondary outcomes are recovery, functioning and quality of life. Data will be collected at baseline and at follow-up at the end of the intervention. Discussion This study adds new knowledge to a field with limited evidence, i.e. the clinical effectiveness of rehabilitation interventions among people with psychiatric disabilities, directly targeting activity engagement. The pragmatic design, regarding in- and exclusion criteria and settings, may allow assessment of the intervention’s effect under real-life conditions. The randomization, adequate power and fidelity monitoring allow testing of the intervention’s efficacy. The multicentre study design increases the potential for implementation in various mental health settings if the findings are positive. As the nature of the intervention does not permit blinding of the participants or staff, it may increase the risk of expectancy and performance bias. This must be considered when interpreting the findings. Trial registration ClinicalTrials.gov NCT03963245. Registered on 29 May 2019
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Affiliation(s)
- Siv Therese Bogevik Bjørkedal
- Team for Inclusion and Recovery, CORE: Copenhagen Research Center for Mental Health, Gentofte Hospitalsvej 15, opg. 3A, 2900, Hellerup, Denmark.
| | - Ulrika Bejerholm
- Department of Health Sciences, Mental Health, Activity and Participation (MAP), Centre for Evidence Based Psychosocial Interventions (CEPI), Lund University, Box 157, SE-221 00, Lund, Sweden
| | - Lene Falgaard Eplov
- Team for Inclusion and Recovery, CORE: Copenhagen Research Center for Mental Health, Gentofte Hospitalsvej 15, opg. 3A, 2900, Hellerup, Denmark
| | - Tom Møller
- CKO University Hospital of Copenhagen Rigshospitalet dep. 8513, 2100, Copenhagen East, Denmark
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Williamson P, Ennals P. Making sense of it together: Youth & families co-create sensory modulation assessment and intervention in community mental health settings to optimise daily life. Aust Occup Ther J 2020; 67:458-469. [PMID: 32648269 DOI: 10.1111/1440-1630.12681] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 05/03/2020] [Accepted: 05/31/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Occupational therapists work collaboratively with young people experiencing mental ill-health to enable meaningful occupational participation in daily life. Sensory modulation is used as a means of developing self-regulation and enabling occupational participation. Published literature on sensory modulation in mental health settings is primarily located within acute inpatient settings and focuses on self-regulation. Little is known about the use of sensory modulation within community settings to enhance occupational participation in daily lives of people with mental-ill health. This study investigated the experiences of young people and their families who engaged in sensory modulation assessment (Adolescent/Adult Sensory Profile) and intervention (between one and twelve sessions) as part of community mental health care at a large area mental health service in Melbourne, Australia. METHODS The qualitative study used naturalistic inquiry methodology involving semi-structured interviews with six young people and three families. Nine interview transcripts were thematically analysed to elicit the experiences of sensory modulation assessment and intervention, and how this may influence daily life. RESULTS Thematic analysis revealed that young people and their families' positive experiences of sensory modulation were underpinned by processes of co-creation: (a) knowing yourself; (b) understanding 'the why': developing shared reasons for engaging in sensory modulation; (c) creating comfort; (d) creating connection; and (e) constantly learning. Sensory modulation supported occupational participation in young peoples' daily lives in the areas of sleep, study, relationships, self-care, independent living, being in the world, and doing new things. CONCLUSION Young people and their families valued the process of co-creating sensory modulation assessment and intervention to enhance occupational participation. Results revealed that sensory modulation assessment and intervention was optimised when it was a process of co-creation. Future research should investigate the effectiveness of sensory modulation in enhancing occupational participation in these domains that influence daily life.
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Affiliation(s)
| | - Priscilla Ennals
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Vic, Australia.,Neami National, Preston, Vic, Australia
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39
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Reed NP, Josephsson S, Alsaker S. A narrative study of mental health recovery: exploring unique, open-ended and collective processes. Int J Qual Stud Health Well-being 2020; 15:1747252. [PMID: 32249712 PMCID: PMC7170373 DOI: 10.1080/17482631.2020.1747252] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Purpose: Guided by narrative theory and by use of a narrative-in-action approach, the aim of this study was to explore how mental health recovery unfolds through individuals’ engagement in everyday activities. Method: Data were created through participant observations with four individuals while doing everyday activities, and analysed through a narrative, interpretive approach. Findings: The findings show how mental health recovery involves unique and open-ended processes of narrative meaning-making, which unfold through an interplay between everyday activities, places and persons. Discussion: Based on these findings, we discuss how we may understand and support mental health recovery as collective processes.
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Affiliation(s)
- Nina Petersen Reed
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Staffan Josephsson
- Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden
| | - Sissel Alsaker
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
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Devine A, Vaughan C, Kavanagh A, Dickinson H, Byars S, Dimov S, Gye B, Brophy L. 'I'm proud of how far I've come. I'm just ready to work': mental health recovery narratives within the context of Australia's Disability Employment Services. BMC Public Health 2020; 20:325. [PMID: 32164650 PMCID: PMC7068916 DOI: 10.1186/s12889-020-8452-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 03/03/2020] [Indexed: 11/10/2022] Open
Abstract
Background Employment is recognised as facilitating the personal and clinical recovery of people with psychosocial disability. Yet this group continue to experience considerable barriers to work, and, constitute a significant proportion of individuals engaged with Disability Employment Services (DES). Recognition of the role of recovery-oriented practice within DES remains limited, despite these approaches being widely promoted as best-practice within the field of mental health. Methods The Improving Disability Employment Study (IDES) aims to gather evidence on factors influencing employment outcomes for Australians with disability. Descriptive analysis and linear regression of IDES survey data from 369 DES participants, alongside narrative analysis of data collected through 56 in-depth interviews with 30 DES participants with psychosocial disability, allowed us to explore factors influencing mental health, well-being and personal recovery within the context of DES. Results Psychosocial disability was reported as the main disability by 48% of IDES respondents. These individuals had significantly lower scores on measures of mental health and well-being (44.9, 48.4 respectively, p ≤ 0.01), compared with respondents with other disability types (52.2, 54.3 p ≤ 0.01). Within this group, individuals currently employed had higher mental health and well-being scores than those not employed (47.5 vs 36.9, 55.5 vs 45.4 respectively, p ≤ 0.01). Building on these findings, our qualitative analysis identified five personal recovery narratives: 1) Recovery in spite of DES; 2) DES as a key actor in recovery; 3) DES playing a supporting role in fluctuating journeys of recovery; 4) Recovery undermined by DES; and, 5) Just surviving regardless of DES. Narratives were strongly influenced by participants’ mental health and employment status, alongside the relationship with their DES worker, and, participants’ perspectives on the effectiveness of services provided. Conclusion These findings re-iterate the importance of work in supporting the mental health and well-being of people with psychosocial disability. Alongside access to secure and meaningful work, personal recovery was facilitated within the context of DES when frontline workers utilised approaches that align with recovery-orientated practices. However, these approaches were not consistently applied. Given the number of people with psychosocial disability moving through DES, encouraging greater consideration of recovery-oriented practice within DES and investment in building the capacity of frontline staff to utilise such practice is warranted.
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Affiliation(s)
- Alexandra Devine
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
| | - Cathy Vaughan
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Anne Kavanagh
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Helen Dickinson
- Public Service Research Group, School of Business, University of New South Wales, Canberra, Australia
| | - Sean Byars
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Stefanie Dimov
- Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Bill Gye
- Community Mental Health Australia, Sydney, Australia
| | - Lisa Brophy
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.,Social Work and Social Policy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
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41
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Petersen KS, Bjørkedal STB, Torsting AM, Eplov LF. Occupational therapy interventions in mental health: a scoping review of recent evidence. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2019. [DOI: 10.12968/ijtr.2016.0070] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/AimsStudies investigating the effect of occupational therapy in mental health are few. This scoping review aims to identify, present and assess studies that have investigated the effect of occupation- and activity-based/focused interventions performed by occupational therapists in mental health.MethodsThe scoping review involved searching six databases, covering articles from 2003 to 2018. ‘The Matrix Method’ was used to describe and synthesise the content of the included studies. The Oxford Level of Evidence was used to rank the evidence, and The Critical Appraisal Skills Programme was used to assess the quality of the study.ResultsA total of 21 original studies and 4 systematic reviews were included in this review. Interventions, approaches, programmes, training, and activities such as cooking, artwork, crafts, pottery, sports, calligraphy, horticulture, and music, organised individually or in groups, were investigated in the included studies. Individualised occupational therapy showed clinically significant improvements in social functioning and cognition, promising results were found on supported employment and education.ConclusionsFew high-quality studies that have investigated the effect of occupation-and activity-based/focused interventions performed by occupational therapists in mental health were found. This scoping review highlights the importance of future high quality studies to support evidence-based practice within mental health occupational therapy.
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Affiliation(s)
- Kirsten Schultz Petersen
- Associate Professor, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Siv Therese Bogevik Bjørkedal
- Assistant Researcher, Program for Research in Rehabilitation, Recovery and Shared Care, Mental Health Center Copenhagen, Hellerup, Denmark
| | - Anne Marie Torsting
- Head of Occupational Therapy, Mental Health Center Sct. Hans, Roskilde, Denmark
| | - Lene Falgaard Eplov
- Senior Consultant, Program for Research in Rehabilitation, Recovery and Shared Care, Mental Health Center Copenhagen, Hellerup, Denmark
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Pothier W, Cellard C, Corbière M, Villotti P, Achim AM, Lavoie A, Turcotte M, Vallières C, Roy MA. Determinants of occupational outcome in recent-onset psychosis: The role of cognition. SCHIZOPHRENIA RESEARCH-COGNITION 2019; 18:100158. [PMID: 31463205 PMCID: PMC6710235 DOI: 10.1016/j.scog.2019.100158] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 07/23/2019] [Accepted: 07/26/2019] [Indexed: 01/18/2023]
Abstract
Working or studying is a common goal among people with recent-onset psychosis. Cognitive deficits have been reported to influence occupational outcome, but to date few studies have evaluated if cognitive deficits independently predict occupational outcome when taking into account other important determinants, such as self-esteem, motivation, length of time absent from employment/school, job/school search behaviours, subjective cognitive complaints and psychotic symptoms. Hence, this longitudinal study aimed to evaluate the role of cognition, as well as other key factors relevant to occupational outcome, to predict occupational status six months after baseline in people with recent-onset psychosis. A total of 27 participants receiving treatment in rehabilitation programs were included in the study. Neuropsychological, psychological, clinical and occupational measures were administered at baseline, and occupational status was collected six months later. Ordinal regression indicated that working memory and length of time absent from employment/school at baseline predicted 48.1% of the variance of occupational status at six months, with both variables showing a unique significant contribution to the model. These results suggest that working memory could be integrated in comprehensive models of occupational outcome in people with recent-onset psychosis. In addition, supported employment and education programs could target cognitive deficits and length of time absent from employment/school to help these individuals to acquire a job or return to school given their strong predictive value on occupational outcome.
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Affiliation(s)
- William Pothier
- École de psychologie de l'Université Laval, 2325 Allée des Bibliothèques, G1V 0A6 Québec, Canada.,Centre de recherche CERVO, 2601 Chemin de la Canardière, G1J 2G3 Québec, Canada
| | - Caroline Cellard
- École de psychologie de l'Université Laval, 2325 Allée des Bibliothèques, G1V 0A6 Québec, Canada.,Centre de recherche CERVO, 2601 Chemin de la Canardière, G1J 2G3 Québec, Canada
| | - Marc Corbière
- Université du Québec à Montréal (UQÀM), 405 Rue Sainte-Catherine Est, H2L 2C4, Montréal, Canada.,Centre de recherche de l'Institut universitaire en santé mentale de Montréal, 7401 Rue Hochelaga, Pavillon Riel, Aile 228, H1N 3M5 Montréal, Canada
| | - Patrizia Villotti
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, 7401 Rue Hochelaga, Pavillon Riel, Aile 228, H1N 3M5 Montréal, Canada
| | - Amélie M Achim
- Centre de recherche CERVO, 2601 Chemin de la Canardière, G1J 2G3 Québec, Canada
| | - Andréanne Lavoie
- École de psychologie de l'Université Laval, 2325 Allée des Bibliothèques, G1V 0A6 Québec, Canada.,Centre de recherche CERVO, 2601 Chemin de la Canardière, G1J 2G3 Québec, Canada
| | - Mélissa Turcotte
- École de psychologie de l'Université Laval, 2325 Allée des Bibliothèques, G1V 0A6 Québec, Canada.,Centre de recherche CERVO, 2601 Chemin de la Canardière, G1J 2G3 Québec, Canada
| | - Chantal Vallières
- Centre de recherche CERVO, 2601 Chemin de la Canardière, G1J 2G3 Québec, Canada
| | - Marc-André Roy
- Centre de recherche CERVO, 2601 Chemin de la Canardière, G1J 2G3 Québec, Canada.,Département de psychiatrie et neurosciences de l'Université Laval, 1050 avenue de la Médecine, G1V 0A6 Québec, Canada
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Mazza D, Chakraborty SP, Brijnath B, Nowak H, Howell C, Brott T, Atchison M, Gras D, Kenardy J, Buchanan R, Tawia S. Diagnosing and managing work-related mental health conditions in general practice: new Australian clinical practice guidelines. Med J Aust 2019; 211:76-81. [PMID: 31231820 PMCID: PMC6852433 DOI: 10.5694/mja2.50240] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Introduction In Australia, mental health conditions (MHCs) arising from workplace factors are a leading cause of long term work incapacity and absenteeism. While most patients are treated in general practice, general practitioners report several challenges associated with diagnosing and managing workplace MHCs. This guideline, approved by the National Health and Medical Research Council and endorsed by the Royal Australian College of General Practitioners and the Australian College of Rural and Remote Medicine, is the first internationally to address the clinical complexities associated with diagnosing and managing work‐related MHCs in general practice. Main recommendations Our 11 evidence‐based recommendations and 19 consensus‐based statements aim to assist GPs with: the assessment of symptoms and diagnosis of a work‐related MHC; the early identification of an MHC that develops as a comorbid or secondary condition after an initial workplace injury; determining if an MHC has arisen as a result of work factors; managing a work‐related MHC to improve personal recovery or return to work; determining if a patient can work in some capacity; communicating with the patient's workplace; and managing a work‐related MHC that is not improving as anticipated.
Changes in management as result of the guideline This guideline will enhance care and improve health outcomes by encouraging: the use of appropriate tools to assist the diagnosis and determine the severity of MHCs; consideration of factors that can lead to the development of an MHC after a workplace injury; more comprehensive clinical assessments; the use of existing high quality guidelines to inform the clinical management of MHCs; consideration of a patient's capacity to work; appropriate communication with the workplace; and collaboration with other health professionals.
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Affiliation(s)
| | | | - Bianca Brijnath
- Monash University, Melbourne, VIC.,National Ageing Research Institute, Melbourne, VIC
| | | | - Cate Howell
- Royal Australian College of General Practitioners, Melbourne, VIC
| | - Trevor Brott
- Western Industrial Screening and Accident Clinic, Melbourne, VIC
| | - Michelle Atchison
- Royal Australian and New Zealand College of Psychiatrists, Melbourne, VIC
| | - David Gras
- Royal Australasian College of Physicians, Melbourne, VIC
| | - Justin Kenardy
- University of Queensland, Brisbane, QLD.,Australian Psychological Society, Melbourne, VIC
| | - Richard Buchanan
- Office of Industrial Relations, Queensland Government, Brisbane, QLD
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Prat G, Ribot A, Recoder S, Muñoz F. Psychometric properties of the Spanish version of the Engagement in Meaningful Activities Survey in people with serious mental illness. Br J Occup Ther 2019. [DOI: 10.1177/0308022619856557] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Gemma Prat
- Grup SaMIS, Divisió de Salut Mental, Fundació Althaia, Manresa (Barcelona), Spain
| | - Arantxa Ribot
- Leisure-Community Intervention, Federació Salut Mental Catalunya, Barcelona, Spain
| | - Sílvia Recoder
- Departament de Ciències Bàsiques, Àrea de Psicologia, Universitat Internacional de Catalunya, Sant Cugat del Vallés (Barcelona), Spain
| | - Francisco Muñoz
- Leisure-Community Intervention, Federació Salut Mental Catalunya, Barcelona, Spain
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45
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De Vos G, Leclair L. Food skills group value, meaning, and use with inpatients in a mental health setting. Br J Occup Ther 2019. [DOI: 10.1177/0308022618823660] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction Occupational therapists use food skills groups to support mental health recovery and engagement in meaningful occupation. Research examining participants’ experiences in these mental health groups is sparse. Method Researchers used a convergent parallel mixed methods design. Following participation in an inpatient food skills group, 60 participants completed a questionnaire, and 20 also participated in a semi-structured interview. The questionnaire data was analysed using descriptive and correlational statistics. The interview data was analysed using thematic analysis. Triangulation was used to combine and interpret findings from the different methods to gain a more complete understanding of the participants’ experiences. Findings Participants strongly agreed/agreed that they enjoyed participating, felt having the opportunity to participate was important to their recovery, and after discharge would use the skills they had learnt. Age, sex, and level of education were associated with some of the questionnaire responses. Three main themes emerged from the interview data: importance of engaging/doing, connections with food, and being involved in a group process. Conclusion Individuals who participated in the food skills group valued having the opportunity to build skills and engage in meaningful activities with others while in hospital. They identified the food skills group as important to their recovery.
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Affiliation(s)
- Gina De Vos
- Winnipeg Regional Health Authority, Winnipeg, MB, Canada
| | - Leanne Leclair
- Department of Occupational Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB, Canada
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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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47
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Aga N, Laenen FV, Vandevelde S, Vermeersch E, Vanderplasschen W. Recovery of Offenders Formerly Labeled as Not Criminally Responsible: Uncovering the Ambiguity From First-Person Narratives. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2019; 63:919-939. [PMID: 28893122 DOI: 10.1177/0306624x17730617] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The recovery paradigm is a widely accepted strength-based approach in general mental health care. Particular challenges arise when applying this paradigm in a forensic context. To address these issues, the present study examined recovery based on first-person narratives of offenders formerly labeled as not criminally responsible of whom the judicial measure was abrogated. Eleven in-depth interviews were conducted to obtain information on lived experiences and recovery resources of this hard-to-reach and understudied population. The interviews focused on recovery and elements that indicated a sense of progress in life. Key themes were derived from the collected data. Descriptions of recovery resources followed recurrent themes, including clinical, functional, social, and personal resources. Participants also reported ambiguous experiences related to features of the judicial trajectory. This was defined as forensic recovery and can be seen as an additional mechanism, besides more established recovery dimensions, that is unique to mentally ill offenders.
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Casey B, Webb M. Imaging Journeys of Recovery and Learning: A Participatory Arts-Based Inquiry. QUALITATIVE HEALTH RESEARCH 2019; 29:833-845. [PMID: 30340448 DOI: 10.1177/1049732318804832] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The relationship between processes of mental health recovery and lifelong learning is an area of increasing international interest. Experiences of transformation, positive effects on self-esteem, self-insight, and empowerment have been identified regarding both endeavors. Recognition of these benefits has stimulated collaborative development of educational programs in personal development, self-efficacy, and recovery principles. The importance of evaluating this educational provision has been emphasized; however, there has been little detailed exploration of students' experiences and perceptions of recovery and learning in the context of recovery education programs. In this article, we present a participatory arts-based inquiry with 14 women, including mental health service users, who undertook a recovery training program to support their roles as mental health support workers in Ireland. Participatory visual analysis revealed three recurring themes; the interrelatedness of learning and recovery journeys, knowledge as a source of stability and rescue and the need for resilience in learning and recovery.
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Potvin O, Vallée C, Larivière N. Experience of Occupations among People Living with a Personality Disorder. Occup Ther Int 2019; 2019:9030897. [PMID: 31049046 PMCID: PMC6458844 DOI: 10.1155/2019/9030897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 12/14/2018] [Accepted: 02/14/2019] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Personality disorders are common mental health disorders, with an estimated lifetime prevalence of 4 to 15%. People living with personality disorders are extensively seeking mental health services, yet few papers focus on their unique occupational needs or effective rehabilitation interventions that may alleviate the occupational issues they face. Occupational therapists are encouraged to support engagement in socially valued occupations, while preventing engagement in damaging ones, despite a lack of evidence on the meaning and the lived experiences of people. OBJECTIVES This paper describes the meaning attributed by people living with personality disorders to their main occupations and the underlying needs they strive to fulfill through occupational engagement, whether or not these occupations are sanctioned. METHODS This exploratory study rests on a descriptive interpretative methodology. The participants were ten men and women, aged between 18 and 35 years old and living with a Cluster B personality disorder. A semistructured interview guide allowed participants to build narratives on occupations that are important to them and discuss how these occupations shape their identity. A thematic content analysis fostered the development of a coding structure that reflected a first-account perspective. RESULTS The narratives provided by the participants depict a variety of meaningful occupations, many of which are socially disapproved. Many of these occupations serve as a coping strategy to deal with distressing situations, to connect with others who share similar life experiences, or to reestablish a fragile sense of control. Other occupations are socially disapproved due to the overinvestment of the participants' commitment. While participants described how this overinvestment allowed them to control destructive impulses, significant others perceived it as counterproductive and unnecessary. Participants perceived self-care occupations as painful and tedious chores or meaningless occupations. Engaging in productive occupations allowed some participants to gain recognition or to identify their competencies, but also confirmed their differences, creating some form of alienation or marginalisation. CONCLUSION This exploratory study invites clinicians and researchers to develop a more responsive understanding of occupational engagement for this population. The results highlight the importance of situating occupations in their context, while endorsing a first-account perspective, to better understand the forces that shape occupational engagement. Ultimately, occupational therapists should critically appraise their assumptions around healthy and unsanctioned occupations, in order to respond with sensitivity to the needs and experience of their clients, without perpetuating the marginalisation and discrimination they face.
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Affiliation(s)
- Olivier Potvin
- Institut de Santé Mentale de Québec, Centre Intégré Universitaire de Santé et Services Sociaux de la Capitale Nationale, Québec, Canada
| | - Catherine Vallée
- Université Laval, Rehabilitation Department, Québec, Québec, Canada
| | - Nadine Larivière
- Université de Sherbrooke, School of Rehabilitation, Sherbrooke, Québec, Canada
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50
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Pérez-Corrales J, Pérez-de-Heredia-Torres M, Martínez-Piedrola R, Sánchez-Camarero C, Parás-Bravo P, Palacios-Ceña D. 'Being normal' and self-identity: the experience of volunteering in individuals with severe mental disorders-a qualitative study. BMJ Open 2019; 9:e025363. [PMID: 30904862 PMCID: PMC6475362 DOI: 10.1136/bmjopen-2018-025363] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 01/14/2019] [Accepted: 01/30/2019] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE This study sought to explore the views and experiences of a group of people with severe mental disorders (SMDs) who performed volunteer services. DESIGN A qualitative phenomenological study. SETTING Community public mental health services of the Community of Madrid and the province of Barcelona (Spain). PARTICIPANTS Purposive sampling techniques were used between September 2016 and April 2017. The inclusion criteria were: individuals aged 18-65 years who participated in volunteer activities during the performance of this study, based on the regulations of volunteer services in Spain and the community of Madrid; a diagnosis of non-organic psychotic disorder (F20.x, F21, F22, F24, F25, F28, F29, F31.x, F32.3 and F33) according to the International Classification of Diseases, 10th Revision; an evolution of ≥2 years; and a moderate to severe dysfunction of global functioning with scores ≤70 in the Global Assessment of Functioning Scale. Ultimately, 23 people with SMD participated in the study with a mean age of 47 years (SD 8.23). METHODS Data were collected through in-depth interviews and researcher field notes. A thematic analysis was performed following appropriate guidelines for qualitative research. RESULTS Two main themes emerged to describe the experience of participating in volunteer activities: (1) rebuilding self-identity, based on the participant's experience of volunteering, of acquiring a new role and a new perceived identity that made them feel valued and respected; and (2) being a so-called normal person with a 'normal' life, based on recovering a sense of normality, unmarked by the illness, thanks to daily responsibilities and occupations. CONCLUSIONS Qualitative research offers insight into the way people with SMD experience volunteering and may help to improve understanding of the underlying motivations that drive these individuals. These findings may be applied to improve guidance during their process of recovery and subsequent inclusion into society.
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Affiliation(s)
- Jorge Pérez-Corrales
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Research Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos (Hum&QRinHS), Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Marta Pérez-de-Heredia-Torres
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Rosa Martínez-Piedrola
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Carlos Sánchez-Camarero
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Paula Parás-Bravo
- Department of Nursing, Nursing Group IDIVAL, Faculty of Nursing, University of Cantabria, Santander, Cantabria, Spain
| | - Domingo Palacios-Ceña
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Research Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos (Hum&QRinHS), Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
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