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Wong R, Podolsky A, Levitt A, Da Silva A, Kodeeswaran S, Markoulakis R. A Qualitative Exploration of Ontario Caregivers' Perspectives of Their Role in Navigating Mental Health and/or Addiction Services for Their Youth. J Behav Health Serv Res 2023; 50:486-499. [PMID: 37311969 DOI: 10.1007/s11414-023-09843-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2023] [Indexed: 06/15/2023]
Abstract
Many youth experiencing mental health and/or addiction (MHA) concerns rely on their caregivers to find and access services. Considering that caregivers often play a significant role in their youth's treatment trajectory, a descriptive qualitative study was used to explore how caregivers (n = 26) in the Greater Toronto Area perceive their role in navigating MHA care for their youth (ages 13 to 26). The Person-Environment-Occupation model was used to guide the thematic analysis. The findings reveal three main themes (1) the internal experience of caregiving, which describes caregivers' emotions and thought processes; (2) the external factors impacting the caregiver's ability to find and access youth MHA services, which explores systemic and social factors that impact navigation; and (3) the demands of the caregiving role. The discussion highlights the importance of supporting the wellbeing of caregivers as they navigate youth MHA services and can provide useful information for healthcare professionals and policy-makers to increase equitable access to youth MHA services.
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Affiliation(s)
- Rachel Wong
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Anna Podolsky
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Anthony Levitt
- Sunnybrook Research Institute, Toronto, ON, Canada
- Family Navigation Project, Sunnybrook Health Sciences Centre, 1929 Bayview Avenue, RM 205, Toronto, ON, M4G 3E8, Canada
- Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | | | - Sugy Kodeeswaran
- Family Navigation Project, Sunnybrook Health Sciences Centre, 1929 Bayview Avenue, RM 205, Toronto, ON, M4G 3E8, Canada
| | - Roula Markoulakis
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada.
- Sunnybrook Research Institute, Toronto, ON, Canada.
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2
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Dir AL, Pederson C, Khazvand S, Schwartz K, Wiehe SE, Aalsma MC. Caregiver and Juvenile Justice Personnel Perspectives on challenges and importance of caregiver engagement and the potential utility of a peer navigator program in the Juvenile Justice System. HEALTH & JUSTICE 2023; 11:30. [PMID: 37542571 PMCID: PMC10403869 DOI: 10.1186/s40352-023-00231-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 07/17/2023] [Indexed: 08/07/2023]
Abstract
BACKGROUND For youth involved in the juvenile justice (JJ) system, caregiver involvement and engagement in the system is crucial for youth development and outcomes of JJ cases; however, there are challenges to establishing positive/productive partnerships between caregivers and JJ representatives. The current project examines perspectives of caregivers and JJ personnel regarding facilitators and barriers to establishing JJ-caregiver partnerships, as well as their perceptions of the use of a caregiver navigator program to support caregivers of system-involved youth. Results are used to inform development of a caregiver navigator program to support caregivers and help them navigate the JJ system. RESULTS Semi-structured interviews were conducted with caregivers of youth involved in JJ (n = 15, 53% White, 93% female), JJ personnel (n = 7, 100% White, 50% female), and JJ family advisory board members (n = 5, 100% Black, 100% female). Caregivers reported varying experiences across intake/arrest, court, and probation processes. Positive experiences were characterized by effective communication and feeling supported by JJ. Negative experiences related to feeling blamed and punished for their child's system involvement and feeling unsupported. JJ interviews corroborated caregiver sentiments and also illustrated facilitators and barriers to JJ-caregiver partnerships. Both JJ personnel and caregivers endorsed potential benefits of a peer-based caregiver navigator program to provide social, informational, and emotional support. CONCLUSION Continued work is needed to improve JJ-caregiver partnerships and use of a peer-based navigator program has the potential to address barriers to caregiver engagement in the JJ system.
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Affiliation(s)
- Allyson L Dir
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA.
- Adolescent Behavioral Health Research Program, Indiana University School of Medicine, Indianapolis, IN, USA.
| | - Casey Pederson
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
- Adolescent Behavioral Health Research Program, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Shirin Khazvand
- Department of Psychology, Indiana University Purdue University Indianapolis, Indianapolis, IN, USA
| | - Katie Schwartz
- Adolescent Behavioral Health Research Program, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Sarah E Wiehe
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
- Indiana Clinical and Translational Sciences Institute, Indianapolis, IN, USA
| | - Matthew C Aalsma
- Adolescent Behavioral Health Research Program, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
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3
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Mullen JN, Levitt A, Markoulakis R. Supporting Individuals with Mental Health and/or Addictions Issues Through Patient Navigation: A Scoping Review. Community Ment Health J 2023; 59:35-56. [PMID: 35648257 DOI: 10.1007/s10597-022-00982-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 05/01/2022] [Indexed: 01/07/2023]
Abstract
Pathways through the mental health care system can be complex and laden with barriers that prevent individuals from finding the most appropriate care. Navigation has been proposed as a solution for improving access to and transition through complex health care systems. While several MHA navigation programs have emerged in the past decade, no study has explored the core themes of MHA navigation, which was the goal of the current review. A scoping review was conducted; the search yielded 11,525 unique results, of which 26 were entered into extraction and subsequent descriptive and thematic analysis. Barrier reduction, client-centered support, and integrated care emerged as the distinct themes underlying MHA services, and overall, navigation significantly improved outcomes for individuals experiencing MHA issues. These findings may support evidence-based implementation of navigation services and point to a need for increased exploration and reporting of MHA navigation outcomes in the literature.
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Affiliation(s)
- Jennifer N Mullen
- Family Navigation Project, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Anthony Levitt
- Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Roula Markoulakis
- Family Navigation Project, Sunnybrook Research Institute, Toronto, ON, Canada.
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada.
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4
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Markoulakis R, Bowles K, Chan S, Weingust S, Dobbin K, Levitt A. Changes in Perception of Caregiving Experience Following Caregiver Peer Support Within a Mental Health and Addictions Navigation Service. Community Ment Health J 2022; 58:740-748. [PMID: 34365586 DOI: 10.1007/s10597-021-00879-6] [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: 03/28/2021] [Accepted: 08/01/2021] [Indexed: 10/20/2022]
Abstract
Interest in navigation services in the mental health and/or addiction (MHA) sphere has grown over the past decade. However, little is known about the value of caregiver peer support in enhancing the navigation process. The Parent Advocate with Lived experience (PAL) service at the Family Navigation Project (FNP) provides peer support to caregivers supporting youth with MHA concerns. Caregivers (n = 26) were asked to rate their perceptions of their caregiver experience retrospectively and then 7 weeks following contact with FNP. A repeated-measures MANOVA comparing participants who had and had not accessed PAL services demonstrated a significant main effect of time, (F(15, 8) = 5.82, p = .008, [Formula: see text] = .916), and a significant time-by-group interaction, (F(15, 8) = 3.69, p = .034, [Formula: see text] = .874), signifying participants who accessed PAL services had more positive perceptions about their caregiving experience compared to participants who had not accessed PAL service. These findings support the future development of caregiver peer support roles within MHA services.
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Affiliation(s)
- Roula Markoulakis
- Family Navigation Project, Sunnybrook Research Institute, 1929 Bayview Avenue, Rm. 215D, Toronto, ON, Canada. .,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada.
| | - Kathryn Bowles
- Family Navigation Project, Sunnybrook Research Institute, 1929 Bayview Avenue, Rm. 215D, Toronto, ON, Canada
| | - Samantha Chan
- Family Navigation Project, Sunnybrook Research Institute, 1929 Bayview Avenue, Rm. 215D, Toronto, ON, Canada
| | - Staci Weingust
- Family Navigation Project, Sunnybrook Research Institute, 1929 Bayview Avenue, Rm. 215D, Toronto, ON, Canada
| | - Kendyl Dobbin
- Family Navigation Project, Sunnybrook Research Institute, 1929 Bayview Avenue, Rm. 215D, Toronto, ON, Canada
| | - Anthony Levitt
- Family Navigation Project, Sunnybrook Research Institute, 1929 Bayview Avenue, Rm. 215D, Toronto, ON, Canada.,Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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5
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Hopkins L, Kuklych J, Pedwell G, Woods A. Supporting the Support Network: The Value of Family Peer Work in Youth Mental Health Care. Community Ment Health J 2021; 57:926-936. [PMID: 32720005 DOI: 10.1007/s10597-020-00687-4] [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: 03/29/2020] [Accepted: 07/18/2020] [Indexed: 11/28/2022]
Abstract
Reported rates of mental illness continue to climb amongst young Australians. In a family environment the carers of these young people play a highly influential role in their recovery process, however this responsibility can also have significant emotional, financial and health impacts on carers. This paper details the findings of an evaluation project examining the impact and effectiveness of a newly developed and implemented Family Peer Support Work model. Benefits were found which included: family care-givers receiving emotional support and empathy; reduced stress, loneliness, isolation and stigma; bridging between the family and the clinical care team; helping families to navigate through the complexities of the care system; and connecting families to other services. Clarity on role definition for the FPSWs evolved over the course of implementation along with a clearer articulation of the model of care and emergent knowledge on useful elements of training, ongoing professional development, mentoring and wellbeing.
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Affiliation(s)
- Liza Hopkins
- Alfred Health, Mental and Addiction Health, 999 Nepean Hwy, Moorabbin, VIC, 3189, Australia.
| | - Jacinta Kuklych
- Alfred Health, Mental and Addiction Health, 999 Nepean Hwy, Moorabbin, VIC, 3189, Australia
| | - Glenda Pedwell
- Alfred Health, Mental and Addiction Health, 999 Nepean Hwy, Moorabbin, VIC, 3189, Australia
| | - Aysha Woods
- Alfred Health, Mental and Addiction Health, 999 Nepean Hwy, Moorabbin, VIC, 3189, Australia
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6
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Godoy L, Hodgkinson S, Robertson HA, Sham E, Druskin L, Wambach CG, Beers LS, Long M. Increasing Mental Health Engagement From Primary Care: The Potential Role of Family Navigation. Pediatrics 2019; 143:peds.2018-2418. [PMID: 30877145 DOI: 10.1542/peds.2018-2418] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/07/2018] [Indexed: 11/24/2022] Open
Abstract
Early engagement in mental health intervention is critical, yet the vast majority of children who are experiencing mental health concerns are not receiving needed services. Pediatric primary care clinics have been recognized as an ideal setting in which to identify and address mental health problems early, although engagement in mental health services within primary care and in community-based settings remains low. Navigators, or individuals with experience in navigating the mental health system, have been highlighted as promising partners in efforts to improve engagement in mental health services. Navigation has a growing body of research support among adults and in targeting medical concerns, but there has been limited research on integrating family navigators into pediatric primary care settings to address mental health concerns. Despite this gap in the evidence base, we believe there is significant promise for the use of this model in addressing children's mental health needs. In this report, we discuss factors contributing to high levels of unmet mental health needs and low levels of engagement in mental health services, the role that navigators can play in increasing engagement in mental health care, and implications and recommendations related to integrating mental health-focused family navigators into pediatric primary care settings.
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Affiliation(s)
- Leandra Godoy
- Division of General and Community Pediatrics, Children's National Health System, Washington, District of Columbia; .,Department of Pediatrics, School of Medicine and Health Sciences, The George Washington University, Washington, District of Columbia
| | - Stacy Hodgkinson
- Division of General and Community Pediatrics, Children's National Health System, Washington, District of Columbia.,Department of Pediatrics, School of Medicine and Health Sciences, The George Washington University, Washington, District of Columbia
| | | | - Elyssa Sham
- Department of Pediatrics, School of Medicine and Health Sciences, The George Washington University, Washington, District of Columbia
| | - Lindsay Druskin
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, Maryland
| | | | - Lee Savio Beers
- Division of General and Community Pediatrics, Children's National Health System, Washington, District of Columbia.,Department of Pediatrics, School of Medicine and Health Sciences, The George Washington University, Washington, District of Columbia
| | - Melissa Long
- Division of General and Community Pediatrics, Children's National Health System, Washington, District of Columbia.,Department of Pediatrics, School of Medicine and Health Sciences, The George Washington University, Washington, District of Columbia
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7
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Broder-Fingert S, Qin S, Goupil J, Rosenberg J, Augustyn M, Blum N, Bennett A, Weitzman C, Guevara JP, Fenick A, Silverstein M, Feinberg E. A mixed-methods process evaluation of Family Navigation implementation for autism spectrum disorder. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2018; 23:1288-1299. [PMID: 30404548 DOI: 10.1177/1362361318808460] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
There is growing interest in Family Navigation as an approach to improving access to care for children with autism spectrum disorder, yet little data exist on the implementation of Family Navigation. The aim of this study was to identify potential failures in implementing Family Navigation for children with autism spectrum disorder, using a failure modes and effects analysis. This mixed-methods study was set within a randomized controlled trial testing the effectiveness of Family Navigation in reducing the time from screening to diagnosis and treatment for autism spectrum disorder across three states. Using standard failure modes and effects analysis methodology, experts in Family Navigation for autism spectrum disorder (n = 9) rated potential failures in implementation on a 10-point scale in three categories: likelihood of the failure occurring, likelihood of not detecting the failure, and severity of failure. Ratings were then used to create a risk priority number for each failure. The failure modes and effects analysis detected five areas for potential "high priority" failures in implementation: (1) setting up community-based services, (2) initial family meeting, (3) training, (4) fidelity monitoring, and (5) attending testing appointments. Reasons for failure included families not receptive, scheduling, and insufficient training time. The process with the highest risk profile was "setting up community-based services." Failure in "attending testing appointment" was rated as the most severe potential failure. A number of potential failures in Family Navigation implementation-along with strategies for mitigation-were identified. These data can guide those working to implement Family Navigation for children with autism spectrum disorder.
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Affiliation(s)
| | - Sarah Qin
- 2 The Children's Hospital of Philadelphia, USA
| | | | | | | | | | | | | | | | | | | | - Emily Feinberg
- 1 Boston University School of Medicine, USA.,5 Boston University School of Public Health, USA
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8
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Markoulakis R, Turner M, Wicik K, Weingust S, Dobbin K, Levitt A. Exploring Peer Support Needs of Caregivers for Youth with Mental Illness or Addictions Concerns in Family Navigation Services. Community Ment Health J 2018; 54:555-561. [PMID: 29143904 DOI: 10.1007/s10597-017-0191-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 11/04/2017] [Indexed: 10/18/2022]
Abstract
Roles for peer support workers are increasingly recognized as a valuable component of mental health and addictions (MHA) services. In youth MHA care, caregivers are often closely involved in finding and accessing services and may also require support for themselves, yet caregiver peer support is not readily available in existing service delivery models. In order to understand the potential role and value of a caregiver peer support worker in a Family Navigation service, a descriptive qualitative study was conducted to explore the needs and potential value of a peer worker from caregiver client perspectives. Study findings indicate that a caregiver peer support worker can provide support for engaging in the caregiving role, utilize lived experience as a skill, and complement navigation support through lived experience. The discussion highlights implications for the implementation of a caregiver peer role at a family-focused service as well as implications for peer work within the MHA system.
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Affiliation(s)
- R Markoulakis
- Family Navigation Project, Sunnybrook Research Institute, 1929 Bayview Avenue, Toronto, ON, M4G 3E8, Canada.
| | - M Turner
- Family Navigation Project, Sunnybrook Research Institute, 1929 Bayview Avenue, Toronto, ON, M4G 3E8, Canada
| | - K Wicik
- Family Navigation Project, Sunnybrook Research Institute, 1929 Bayview Avenue, Toronto, ON, M4G 3E8, Canada
| | - S Weingust
- Family Navigation Project, Sunnybrook Research Institute, 1929 Bayview Avenue, Toronto, ON, M4G 3E8, Canada
| | - K Dobbin
- Family Navigation Project, Sunnybrook Research Institute, 1929 Bayview Avenue, Toronto, ON, M4G 3E8, Canada
| | - A Levitt
- Family Navigation Project, Sunnybrook Research Institute, 1929 Bayview Avenue, Toronto, ON, M4G 3E8, Canada.,Department of Psychiatry, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.,Department of Psychiatry, University of Toronto, 250 College Street, Toronto, ON, M5T 1R8, Canada
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9
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Williams LA, Moeke-Maxwell T, Wiles J, Black S, Trussardi G, Kerse N, Gott M. How family caregivers help older relatives navigate statutory services at the end of life: A descriptive qualitative study. Palliat Med 2018; 32:1124-1132. [PMID: 29667475 DOI: 10.1177/0269216318765853] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: A key challenge in meeting the palliative care needs of people in advanced age is the multiple healthcare and social service agencies typically involved in their care. The ‘patient navigator’ model, originally developed in cancer care, is the professional solution most often recommended to address this challenge. However, little attention has been paid, or is known, about the role that family carers play in enabling their dying relatives to negotiate service gaps. Aim: To explore the role family caregivers play in helping people dying in advanced old age navigate health services at the end of life. Design: Qualitative study using semi-structured interviews and analysed via thematic analysis. Setting/participants: A total of 58 interviews were conducted in New Zealand with the family caregivers of 52 deceased older relatives who had been participants in Life and Living in Advanced Age: a Cohort Study in New Zealand. Results: Fragmentation of services was the key concern, causing distress both for the older person and their family caregivers. Carers identified and engaged with appropriate services in order to facilitate care and treatment. Their involvement was not always met by healthcare professionals with respect or regard to their knowledge of the older person’s needs. Conclusion: Family caregivers are trying to help their older relatives overcome the limitations of fragmented health systems at the end of life. They are doing so at times by stepping in to perform patient navigator tasks usually conceptualised as a role for statutory services to carry out. Programmes and services need to be implemented that will better support family carers who are acting as care navigators.
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Affiliation(s)
- Lisa Ann Williams
- 1 School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Tess Moeke-Maxwell
- 1 School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Janine Wiles
- 2 School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Stella Black
- 1 School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Gabriella Trussardi
- 1 School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Ngaire Kerse
- 2 School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Merryn Gott
- 1 School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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10
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Myers NAL, Smith K, Pope A, Alolayan Y, Broussard B, Haynes N, Compton MT. A Mixed-Methods Study of the Recovery Concept, "A Meaningful Day," in Community Mental Health Services for Individuals with Serious Mental Illnesses. Community Ment Health J 2016; 52:747-56. [PMID: 26659600 DOI: 10.1007/s10597-015-9971-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 11/13/2015] [Indexed: 11/24/2022]
Abstract
The recovery concept encompasses overcoming or managing one's illness, being physically and emotionally healthy, and finding meaningful purpose through work, school, or volunteering, which connects one to others in mutually fulfilling ways. Using a mixed-methods approach, we studied the emphasis on "a meaningful day" in the new Opening Doors to Recovery (ODR) program in southeast Georgia. Among 100 participants, we measured the meaningful day construct using three quantitative items at baseline (hospital discharge) and at 4-, 8-, and 12-month follow-up, finding statistically significant linear trends over time for all three measures. Complementary qualitative interviews with 30 individuals (ODR participants, family members, and ODR's Community Navigation Specialists and program leaders) revealed themes pertaining to companionship, productivity, achieving stability, and autonomy, as well as the concern about insufficient resources. The concept of "a meaningful day" can be a focus of clinical attention and measured as a person-centered outcome for clients served by recovery-oriented community mental health services.
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Affiliation(s)
- Neely A L Myers
- Department of Anthropology, Dedman College of Humanities and Sciences, Southern Methodist University, Dallas, TX, USA
| | - Kelly Smith
- Pineland Behavioral Health/Developmental Disabilities, Statesboro, GA, USA
| | - Alicia Pope
- Pineland Behavioral Health/Developmental Disabilities, Statesboro, GA, USA
| | - Yazeed Alolayan
- Department of Psychiatry and Behavioral Sciences, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Beth Broussard
- Department of Psychiatry, Lenox Hill Hospital, 111 E. 77th Street, New York, NY, 10075, USA
| | - Nora Haynes
- Savannah Affiliate of the National Alliance on Mental Illness, Savannah, GA, USA
| | - Michael T Compton
- Department of Psychiatry, Lenox Hill Hospital, 111 E. 77th Street, New York, NY, 10075, USA. .,Department of Psychiatry, Hofstra North Shore - LIJ School of Medicine at Hofstra University, Hempstead, NY, USA.
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